HMS gets data from the 1500 and UB-04 forms.

The color of the HMS text matches the color of the 1500 and/or UB-04 field where the data comes from.

HMS Patient Fields:

• 17 PAT-LAST-NAME
• 18 PAT-FIRST-NAME
• 19 PAT-MID-INIT
• 20 PAT-SEX
• 21 PAT-DOB-CCYYMMDD