| 85396-0 | IRF-PAI - Facility information:-:RptPeriod:^Patient:-:CMS Assessment | |
| 85396-0 | IRF-PAI - Facility information:-:RptPeriod:^Patient:-:CMS Assessment | |
| 85396-0 | IRF-PAI - Facility information:-:RptPeriod:^Patient:-:CMS Assessment | |
| 85396-0 | IRF-PAI - Facility information:-:RptPeriod:^Patient:-:CMS Assessment | |
| 45397-7 | Medicare or comparable # | |
| 45397-7 | Medicare or comparable # | |
| 45397-7 | Medicare or comparable # | |
| 45397-7 | Medicare or comparable # | |
| 45400-9 | Medicaid # | |
| 45400-9 | Medicaid # | |
| 45400-9 | Medicaid # | |
| 45400-9 | Medicaid # | |
| 45392-8 | Patient First name | |
| 45392-8 | Patient First name | |
| 45392-8 | Patient First name | |
| 45392-8 | Patient First name | |
| 45394-4 | Patient Last name | |
| 45394-4 | Patient Last name | |
| 45394-4 | Patient Last name | |
| 45394-4 | Patient Last name | |
| 52463-7 | Patient ID # or Provider Acct # | |
| 52463-7 | Patient ID # or Provider Acct # | |
| 52463-7 | Patient ID # or Provider Acct # | |
| 52463-7 | Patient ID # or Provider Acct # | |
| 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 # | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 59362-4 | Race or ethnicity OMB.1997 | |
| 59362-4 | Race or ethnicity OMB.1997 | |
| 59362-4 | Race or ethnicity OMB.1997 | |
| 59362-4 | Race or ethnicity OMB.1997 | |
| 45404-1 | Marital status | |
| 45404-1 | Marital status | |
| 45404-1 | Marital status | |
| 45404-1 | Marital status | |
| 52539-4 | Prior postal code | |
| 52539-4 | Prior postal code | |
| 52539-4 | Prior postal code | |
| 52539-4 | Prior postal code | |
| 52455-3 | Admission date | |
| 52455-3 | Admission date | |
| 52455-3 | Admission date | |
| 52455-3 | Admission date | |
| 54593-9 | Assessment reference date - observation end date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 54593-9 | Assessment reference date - observation end date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 54593-9 | Assessment reference date - observation end date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 54593-9 | Assessment reference date - observation end date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 85397-8 | Inpatient rehabilitation facility admission:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 85397-8 | Inpatient rehabilitation facility admission:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 85397-8 | Inpatient rehabilitation facility admission:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 85397-8 | Inpatient rehabilitation facility admission:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 85398-6 | Admitted from:Type:Pt:Facility:Nom: | |
| 85398-6 | Admitted from:Type:Pt:Facility:Nom: | |
| 85398-6 | Admitted from:Type:Pt:Facility:Nom: | |
| 85398-6 | Admitted from:Type:Pt:Facility:Nom: | |
| 85399-4 | Prior residence:Type:Pt:^Patient:Nom: | |
| 85399-4 | Prior residence:Type:Pt:^Patient:Nom: | |
| 85399-4 | Prior residence:Type:Pt:^Patient:Nom: | |
| 85399-4 | Prior residence:Type:Pt:^Patient:Nom: | |
| 85400-0 | Prior living arrangement:Find:RptPeriod:^Patient:Nom:CMS Assessment | |
| 85400-0 | Prior living arrangement:Find:RptPeriod:^Patient:Nom:CMS Assessment | |
| 85400-0 | Prior living arrangement:Find:RptPeriod:^Patient:Nom:CMS Assessment | |
| 85400-0 | Prior living arrangement:Find:RptPeriod:^Patient:Nom:CMS Assessment | |