The Case
I have a flow in Power Automate where I need to lookup an item in a SharePoint list based on two lookup columns (in this example, the two lookup columns are called Patient and Exercise). I know that there will be one and only one item in the list with the combination of Patient and Exercise.
The Solution
In Power Automate we need to use the SharePoint action “Get items” to be able to query the list for items based on the two input variables. To be able to address the lookup fields in the query, we add an “Id” suffix to the column name (the Exercise lookup column is referenced by “ExerciseId”). The filter query in this case is shown in the image below:

The “Get Items” action returns an array of results, so we need to pick the first item in the array. This can be done by using the “Compose” action. This action can read the result from the previous action and we can compose a new output. In this case we update a variable with the output. We use the first(…) function to get the first item (Value), and we pick the ID use the following expression:
first(body(‘Get_items’)?[‘Value’])?[‘ID’]
The image below shows the details:

Thank-you. Exactly what I needed to save me Apply to Each Hell.
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