| 58198-3 | Type of record:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 54581-4 | Facility provider #s | |
| 85632-8 | Facility type:Type:RptPeriod:Facility:Nom:CMS Assessment | |
| 54593-9 | Assessment reference date - observation end date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 52455-3 | Admission date | |
| 52454-6 | Reason for assessment:Find:Pt:^Patient:Nom: | |
| 93229-3 | LCDS v5.00 - Patient demographic information - admission:-:RptPeriod:^Patient:-:CMS Assessment | |
| 85815-9 | LCDS - Pre-admission service use:-:RptPeriod:^Patient:-:CMS Assessment | |