| 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 | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 21112-8 | Birth date | |
| 21112-8 | Birth date | |
| 45396-9 | Social Security # | |
| 45396-9 | Social Security # | |
| 90522-4 | Assessment for state payment:Find:RptPeriod:^Patient:Ord:CMS Assessment | |
| 91580-1 | MDS v3.0 - RAI v1.17.2 - Type of assessment on existing record to be modified or inactivated - IPA:-:RptPeriod:^Patient:-:CMS Assessment | |
| 91580-1 | MDS v3.0 - RAI v1.17.2 - Type of assessment on existing record to be modified or inactivated - IPA:-:RptPeriod:^Patient:-:CMS Assessment | |
| 87216-8 | Date on existing record to be modified or inactivated:-:RptPeriod:^Patient:-:CMS Assessment | |
| 54593-9 | Assessment reference date - observation end date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 87209-3 | Correction attestation section:-:RptPeriod:^Patient:-:CMS Assessment | |
| 87209-3 | Correction attestation section:-:RptPeriod:^Patient:-:CMS Assessment | |