| 68468-8 | Attending physician NPI:ID:Pt:Provider:Nom: | |
| 68468-8 | Attending physician NPI:ID:Pt:Provider:Nom: | |
| 68468-8 | Attending physician NPI:ID:Pt:Provider:Nom: | |
| 69417-4 | CMS certification # Fclty | |
| 69417-4 | CMS certification # Fclty | |
| 69417-4 | CMS certification # Fclty | |
| 46494-1 | State location of agency branch:Loc:RptPeriod:Agency:Nom:CMS Assessment | |
| 46494-1 | State location of agency branch:Loc:RptPeriod:Agency:Nom:CMS Assessment | |
| 46494-1 | State location of agency branch:Loc:RptPeriod:Agency:Nom:CMS Assessment | |
| 46495-8 | Branch number:ID:RptPeriod:Agency:Nom:CMS Assessment | |
| 46495-8 | Branch number:ID:RptPeriod:Agency:Nom:CMS Assessment | |
| 46495-8 | Branch number:ID:RptPeriod:Agency:Nom:CMS Assessment | |
| 46496-6 | Agency patient number:ID:RptPeriod:^Patient:Nom:CMS Assessment | |
| 46496-6 | Agency patient number:ID:RptPeriod:^Patient:Nom:CMS Assessment | |
| 46496-6 | Agency patient number:ID:RptPeriod:^Patient:Nom:CMS Assessment | |
| 54503-8 | Legal name of patient:-:Pt:^Patient:-: | |
| 54503-8 | Legal name of patient:-:Pt:^Patient:-: | |
| 54503-8 | Legal name of patient:-:Pt:^Patient:-: | |
| 46499-0 | State of residence | |
| 46499-0 | State of residence | |
| 46499-0 | State of residence | |
| 45401-7 | Postal code | |
| 45401-7 | Postal code | |
| 45401-7 | Postal code | |
| 45396-9 | Social Security # | |
| 45396-9 | Social Security # | |
| 45396-9 | Social Security # | |
| 45397-7 | Medicare or comparable # | |
| 45397-7 | Medicare or comparable # | |
| 45397-7 | Medicare or comparable # | |
| 45400-9 | Medicaid # | |
| 45400-9 | Medicaid # | |
| 45400-9 | Medicaid # | |
| 46098-0 | Sex | |
| 46098-0 | Sex | |
| 21112-8 | Birth date | |
| 21112-8 | Birth date | |
| 69854-8 | Hispanic, latino-a, or spanish | |
| 21112-8 | Birth date | |
| 46098-0 | Sex | |
| 69854-8 | Hispanic, latino-a, or spanish | |
| 69854-8 | Hispanic, latino-a, or spanish | |
| 103708-4 | Race:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 103708-4 | Race:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 103708-4 | Race:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 57199-2 | Current payment sources for home care:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 57199-2 | Current payment sources for home care:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 57199-2 | Current payment sources for home care:Type:RptPeriod:^Patient:Nom:CMS Assessment | |
| 93186-5 | Preferred lang + interp need | |
| 93186-5 | Preferred lang + interp need | |
| 93186-5 | Preferred lang + interp need | |
| 46497-4 | Start of care date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 46497-4 | Start of care date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 46497-4 | Start of care date:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 46500-5 | Discipline of person completing assessment:Type:RptPeriod:Provider:Nom:CMS Assessment | |
| 46500-5 | Discipline of person completing assessment:Type:RptPeriod:Provider:Nom:CMS Assessment | |
| 46500-5 | Discipline of person completing assessment:Type:RptPeriod:Provider:Nom:CMS Assessment | |
| 46501-3 | Date assessment information completed:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 46501-3 | Date assessment information completed:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 46501-3 | Date assessment information completed:Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 57200-8 | Reason for assessment:Find:RptPeriod:^Patient:Nom:CMS Assessment | |
| 57200-8 | Reason for assessment:Find:RptPeriod:^Patient:Nom:CMS Assessment | |
| 57200-8 | Reason for assessment:Find:RptPeriod:^Patient:Nom:CMS Assessment | |
| 57201-6 | Date of Physician-ordered Start of Care (Resumption of Care):Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 57201-6 | Date of Physician-ordered Start of Care (Resumption of Care):Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 57201-6 | Date of Physician-ordered Start of Care (Resumption of Care):Date:RptPeriod:^Patient:Qn:CMS Assessment | |
| 57202-4 | Date of Referral:Date:Pt:^Patient:Qn: | |
| 57202-4 | Date of Referral:Date:Pt:^Patient:Qn: | |
| 57202-4 | Date of Referral:Date:Pt:^Patient:Qn: | |
| 57203-2 | Episode Timing:Find:RptPeriod:^Patient:Ord:CMS Assessment | |
| 101351-5 | Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living:Find:RptPeriod:^Patient:Nom:CMS Assessment | |
| 101351-5 | Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living:Find:RptPeriod:^Patient:Nom:CMS Assessment | |
| 57204-0 | Inpatient discharge facility within the past 14D:Type:14D:^Patient:Nom:CMS Assessment | |
| 57204-0 | Inpatient discharge facility within the past 14D:Type:14D:^Patient:Nom:CMS Assessment | |
| 101351-5 | Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living:Find:RptPeriod:^Patient:Nom:CMS Assessment | |
| 57204-0 | Inpatient discharge facility within the past 14D:Type:14D:^Patient:Nom:CMS Assessment | |
| 86470-2 | Most recent inpatient discharge date in the last 14D:Date:14D:^Patient:Qn:CMS Assessment | |
| 86470-2 | Most recent inpatient discharge date in the last 14D:Date:14D:^Patient:Qn:CMS Assessment | |
| 86470-2 | Most recent inpatient discharge date in the last 14D:Date:14D:^Patient:Qn:CMS Assessment | |