Visit Type

Displays Visit Type from the main Visit form

Visit Date

Displays Visit Date (Service Date) from the main Visit form

Anesthesiologist

Enter of select the first Anesthesiologist on the visit

Anesthetist

Enter or select the first Anesthetist on the visit

Surgeon

Enter or select the Surgeon on the visit

Facility

Enter or select the Facility in which the procedure was performed

Location

Enter or select the Location (Place of Service) in which the procedure was performed

PCP

Enter/Select the Primary Care Provider for the patient on the visit

OR Suite

Enter or select the O/R Suite in which the procedure was performed

Anes Type

Enter or select the anesthesia type which was used for the procedure