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seqtypeoptdescriptionvalue
2RElation Patient ID(Elation Patient ID)
4RAlternate Patient ID(Elation Patient ID)
5.1RPatient Last Name
5.2RPatient First Name
5.3OPatient Middle Name
7YYYYMMDDRPatient Date of Birth
8RPatient Gender’M’ - Male ‘F’ - Female ‘N’ - Not Indicated
10RPatient Race’1002-5’ - American Indian or Alaska Native ‘2028-9’ - Asian ‘2054-5’ - Black or African American ‘2076-8’ - Native Hawaiian or Other Pacific Islander ‘2106-3’ - White ‘2131-1’ - Other Race ‘0000-0’ - Declined To Specify
11.1OPatient Address Line 1
11.2OPatient Address Line 2
11.3OPatient City
11.4OPatient State
11.5OPatient Zip Code
13.1OPatient Phone Number
13.2OPatient Phone Number Equipment Type’CP’ - Cell Phone ‘PH’ - Telephone
13.4OPatient Email
14.1OAlternate Patient Phone Number
14.2OAlternate Patient Phone Number Equipment Type’CP’ - Cell Phone ‘PH’ - Telephone
18.1OSecondary Practice Identifier
18.4OBill Type’C’ - Client ‘P’ - Patient ‘T’ - Third Party Billing
22OPatient ethnicity’2135-2’ - Hispanic or Latino ‘2186-5’ - Not Hispanic or Latino
PID 18.1 is a secondary practice identifier it can be used if a practice has multiple locations that need separate identification. 
PID|1|1234567891011||1234567891011|LAST^FIRST^MIDDLE||19600120|F|||100 ANY ST^^ANY TOWN^CA^12345|||||||12345678^^^T