Group: Group or population within your organization that the patient is assigned to (if any)

Middle_Name: It is best to use a space between multiple middle names.

Name_Suffix: The following values are acceptable: Sr., Jr., III

Home_Phone: Acceptable formats: 9999999999 or 999-999-9999

Work_Phone: Acceptable formats: 9999999999 or 999-999-9999

Cell_Phone: Acceptable formats: 9999999999 or 999-999-9999

Practice: The name of the practice associated with this patient panel.

Location: Practice location. Ex: 123 Main St Washington DC 20672

PCP: Patient’s Primary Care Provider

NPI: PCP’s 10-digit National Provider Identifier. Acceptable format: 1111111111

TaxID: Organization’s associated 9-digit Taxpayer Identification Number.

Insurance: Patient’s insurance provider. Ex: CareFirst BCBS

ACO: Patient’s Accountable Care Organization

Account_Number

CEND_Startdate: M/D/YYYY or MM/DD/YYYY is acceptable.

Care_Program: Name of care program within your organization the consumer is affliated with (if any)

Care_Program_StartDt: M/D/YYYY or MM/DD/YYYY is acceptable.

Care_Program_EndDt: M/D/YYYY or MM/DD/YYYY is acceptable.

Care_Manager: Patient’s Care Manager within your organization.

Care_Manager_Phone: Patient’s care manager’s phone number contact.

Care_Manager_Email: Patient’s care manager’s email contact. Ex: abc@ainq.direct.org

RiskScore1

RiskMethodology1

RiskScore2

RiskMethodology2

Region: CRISP Region is associated with your organization (AK).

DirectEmail: Patient’s email address. Ex: abc@ainq.direct.org

DocHaloID

Follow_Up_Date

Appointment_Missed_Date