History
"ADL"
"HistoryPastMedical"
"HistoryFamily"
"InsClaimNumber"
"InsPolicyNumber"
"WorkRestrictions"
"ExamGeneralPhysical"
Auto Accident History
"AutoAccidentDate"
"AutoAccidentTime"
"HistoryAuto"
Workers Compensation
"HistoryWork"
"WorkInjuryDate"
"WorkInjuryTime"
Subjective
"SubjectiveCurrent"
"SubjectiveInitial"
"SubjectiveOther"
Objective Palpation
"ExamPalpationInitial"
"ExamPalpationCurrent"
"ExamPalpationOther"
Objective Ortho/Neuro
"ExamOrthoNeuroCurrent"
"ExamOrthoNeuroInitial"
"ExamOrthoNeuroOther"
Objective Range of Motion
"RangeOfMotionInitial"
"RangeOfMotionCurrent"
"RangeOfMotionOther"
Objective Xray Merge Fields
"XrayDateCurrent"
"XrayFindingCurrent"
"XrayImpressionCurrent"
"XrayDateInitial"
"XrayFindingInitial"
"XrayImpressionInitial"
Assessment
"AssessmentCurrent"
Diagnosis
"DiagnosisCurrent"
"DiagnosisInitial"
"DiagnosisOther"
Prognosis
"PrognosisInitial"
"PrognosisCurrent"
Plan
"PlanInitial"
"PlanCurrent"
"PlanOther"
Recipient
"RecipientCatalog"
"RecAddress"
"RecCity"
"RecFirst"
"RecLast"
"RecPrefix"
"RecState"
"RecZIP"
Personal
"Chart"
"Full Name"
"Title"
"First"
"Initial"
"Last"
"Suffix"
"Nickname"
"Full Address"
"Address"
"City"
"State"
"Zip"
"Race"
"Sex"
"DOB"
"Admitted"
"Home Phone"
"Work Phone"
"SSN"
Financial
"Patient Balance"
"Insurance Balance"
"Total Balance"
"Past Due Date"
"Past Due Time Period"
"Minimum Due"
"Past Due"
"Receipt Transactions"
"PRPATTAX"
"PRINSTAX"
"PRTOTTAX"
Provider
"Provider Formal Name"
"Provider Casual Name"
"Provider Clinic"
"Provider Address"
"Provider Full Address"
"Provider City"
"Provider State"
"Provider Zip"
"Provider EIN"
"Provider TIN"
"Provider SSN"
"Provider State License"
"Provider Phone"
"Provider Fax"
"Collection Manager Full Name"
Treatment
"SOAP Date"
"SOAP Note"
"ICD Diagnosis"
"Custom Diagnosis"
Carrier/Adjuster Info
"Adjuster Full Name"
"Adjuster First"
"Adjuster Last"
"Adjuster MI"
"Adjuster Title"
"Carrier Address"
"Carrier City"
"Carrier State"
"Carrier Zip"
"Adjuster Phone"
"Adjuster Fax"
"Insured ID"
Visit Information
"Last Visit Date"
Other
"Current Date"
"He/She"
"His/Her"
"Referred by"
Recipient
"Recipient Catalog"
"Ask For Recipient Full Name"
"Ask For Recipient First Name"
"Ask For Recipient Last Name"
"Ask For Recipient Address"
"Ask For Recipient City"
"Ask For Recipient State"
"Ask For Recipient Zip"
Employer
"Employer Name"
"Employer Address"
"Employer City"
"Employer State"
"Employer Zip"
"Employer Phone"
"Employer Fax"
"School Name"
Attorney
"Attorney Firm"
"Attorney Contact"
"Attorney Address"
"Attorney City"
"Attorney State"
"Attorney Zip"
"Attorney Phone"
"Attorney Fax"