| 76435-7 | Pt ID | |
| 76698-0 | Pt ID assign auth | |
| 76471-2 | Organization EOC unique ID | |
| 76470-4 | Federal employer tax ID Organization | |
| 76696-4 | Name Fclty | |
| 45394-4 | Patient Last name | |
| 45392-8 | Patient First name | |
| 52461-1 | Patient middle name | |
| 21112-8 | Birth date | |
| 72143-1 | Sex:Type:Pt:^Patient:Nom:HL7.v3 | |
| 76458-9 | Patient Email address | |
| 76423-3 | Date of first visit | |
| 76417-5 | Provider First name | |
| 76419-1 | Provider Last name | |
| 45952-9 | National provider ID:ID:Pt:Provider:Nom: | |
| 92707-9 | Care team info Pnl | |
| 92563-6 | PT health concerns Pnl | |
| 92562-8 | PT goals Pnl | |
| 92566-9 | Planned intervention or services Pnl | |