| 85632-8 | Facility type:Type:RptPeriod:Facility:Nom:CMS Assessment | |
| 85632-8 | Facility type:Type:RptPeriod:Facility:Nom:CMS Assessment | |
| 85632-8 | Facility type:Type:RptPeriod:Facility:Nom:CMS Assessment | |
| 85632-8 | Facility type:Type:RptPeriod:Facility:Nom:CMS Assessment | |
| 85632-8 | Facility type:Type:RptPeriod:Facility:Nom:CMS Assessment | |
| 85632-8 | Facility type:Type:RptPeriod:Facility:Nom:CMS Assessment | |
| 87226-7 | First and last name | |
| 87226-7 | First and last name | |
| 87226-7 | First and last name | |
| 87226-7 | First and last name | |
| 87226-7 | First and last name | |
| 87226-7 | First and last name | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 21112-8 | Birth date | |
| 21112-8 | Birth date | |
| 21112-8 | Birth date | |
| 21112-8 | Birth date | |
| 21112-8 | Birth date | |
| 21112-8 | Birth date | |
| 45396-9 | Social Security # | |
| 45396-9 | Social Security # | |
| 45396-9 | Social Security # | |
| 45396-9 | Social Security # | |
| 45396-9 | Social Security # | |
| 45396-9 | Social Security # | |
| 86524-6 | Type of assessment:-:RptPeriod:^Patient:-:CMS Assessment | |
| 86524-6 | Type of assessment:-:RptPeriod:^Patient:-:CMS Assessment | |
| 86524-6 | Type of assessment:-:RptPeriod:^Patient:-:CMS Assessment | |
| 86524-6 | Type of assessment:-:RptPeriod:^Patient:-:CMS Assessment | |
| 86524-6 | Type of assessment:-:RptPeriod:^Patient:-:CMS Assessment | |
| 86524-6 | Type of assessment:-:RptPeriod:^Patient:-:CMS Assessment | |
| 87216-8 | Date on existing record to be modified or inactivated:-:RptPeriod:^Patient:-:CMS Assessment | |
| 87216-8 | Date on existing record to be modified or inactivated:-:RptPeriod:^Patient:-:CMS Assessment | |
| 87216-8 | Date on existing record to be modified or inactivated:-:RptPeriod:^Patient:-:CMS Assessment | |
| 87216-8 | Date on existing record to be modified or inactivated:-:RptPeriod:^Patient:-:CMS Assessment | |
| 87216-8 | Date on existing record to be modified or inactivated:-:RptPeriod:^Patient:-:CMS Assessment | |
| 87216-8 | Date on existing record to be modified or inactivated:-:RptPeriod:^Patient:-:CMS Assessment | |