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→Interpretation/Translation Fields
|10||ReferralCity||Referral City||Alpha||
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|11||ReferralProvince/State||Referral Province/State||Alpha||
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|12||ReferralPostalCode||Referral PostalCodePostal Code||Alpha||
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|13||ReferralCountry||Referral Country||Alpha||
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|14||ReferralFileNumber||Referral FileNumberFile Number (system)||Alpha||
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|15||ReferralPhoneNumber||Referral Phone Number||Alpha||
|20||ClaimantLastName||Claimant Last Name||Alpha||
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|21||ClaimantApt/Suite||Claimant Apt/Suite||Alpha||
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|22||ClaimantBuzzer||Claimant Buzzer||Alpha||
|24||ClaimantCity||Claimant City||Alpha||
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|25||ClaimantProvince/State||Claimant Province/State||Alpha||
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|26||ClaimantPostalCode||Claimant PostalCodePostal Code||Alpha||
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|27||ClaimantCountry||Claimant Country||Alpha||
|29||ClaimantFax||Claimant Fax||Alpha||
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|30||ClaimFile||Claim FileNumber||Alpha||
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|31||DateofLoss||Dateof Date of Loss||Date/Time||YYYY-MM-DD
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|32||ClaimantPolicyNumber||Claimant Policy Number||Alpha||
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|33||ClaimantP.O.BoxClaimantPOBox||Claimant P.O. Box||Alpha||
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|33||Billingsameasreferral||Billing same as referral||Numeric||1=Yes;2=No
|38||BillingCity||Billing City||Alpha||
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|39||BillingProvince/State||Billing Province/State||Alpha||
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|40||BillingPostalCode||Billing Postal Code||Alpha||
|43||BillingEmail||Billing Email||Alpha||
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|44||BillingP.O.BoxBillingPOBox||Billing P.O. Box||Alpha||
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! style="color: black; background-color: #62BC43;"|Appointment Details !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
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|45||FaxconfirmationofappointmentFaxconfirmation||Fax confirmation of appointment||Numeric||1=Yes;2=No
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|46||EmailconfirmationofappointmentEmailconfirmation||Email confirmation of appointment||Numeric||1=Yes;2=No
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|47||PhoneconfirmationofappointmentPhoneconfirmation||Phone confirmation of appointment||Numeric||1=Yes;2=No
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|48||Notes||Notes||Alpha||
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|49||ArrangeAppointmentwithclaimantArrangeAppointment||Arrange Appointment with claimant/patient||Numeric||1=Yes;2=No
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|50||ConfirmAppointmentwithclaimantConfirmAppointment||Confirm Appointment with claimant/patient||Numeric||1=Yes;2=No
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|51||DateandTime||Date and Time of appointment||Date/Time||YYYY-MM-DDHH:MM:SS
|56||GenderofInterpreter||Gender of Interpreter||Numeric||1=Male;2=Female;3=NoPreferences
|}
===Transportation Fields===
