| Name | Description | |
| Other Procedure 1 Code | Displays the chosen code in the 1st "Other Procedure" selection field. | |
| Other Procedure 2 Code | Displays the chosen code in the 2nd "Other Procedure" selection field. | |
| Other Procedure 3 Code | Displays the chosen code in the 3rd "Other Procedure" selection field. | |
| Other Procedure 4 Code | Displays the chosen code in the 4th "Other Procedure" selection field. | |
| Other Procedure 5 Code | Displays the chosen code in the 5th "Other Procedure" selection field. | |
| Principle Procedure Code |
| |
| Other Procedure 1 Date | Displays the chosen procedure's date in the 1st "Other Procedure" selection field. | |
| Other Procedure 1 Date | Displays the chosen procedure's date in the 2nd "Other Procedure" selection field. | |
| Other Procedure 1 Date | Displays the chosen procedure's date in the 3rd "Other Procedure" selection field. | |
| Other Procedure 1 Date | Displays the chosen procedure's date in the 4th "Other Procedure" selection field. | |
| Other Procedure 1 Date | Displays the chosen procedure's date in the 5th "Other Procedure" selection field. | |
| Principle Procedure Date | Displays the chosen procedure's date in the "Principal Diagnosis" selection field. |