First Name
Last Name
Gender
Date of Birth
Last 4 Digits of SSN
Home Phone
Mobile Phone
External ID
Address Lines 1 & 2
City & State
Zip Code
Country
Diagnosis Code
Therapeutic Category
Drug (Product) Name
Activity Status
Activity Complete Date
Activity Due Date
Activity Name
Activity URL
Minimum version: 2020R1
Fee charged by dispensing system: Yes
Dispensing system test instance provided without additional fee: No