| 18647-8 | Psychiatric rehabilitation treatment plan, Date attending MD signed Date and time |
| 27493-6 | Alcohol-substance abuse rehabilitation treatment plan, Date attending MD signed Date and time |
| 27541-2 | Cardiac rehabilitation treatment plan, Date attending MD signed Date and time |
| 27563-6 | Skilled nursing treatment plan, Date attending MD signed Date and time |
| 27614-7 | Occupational therapy treatment plan, Date attending MD signed Date and time |
| 27677-4 | Physical therapy treatment plan, Date attending MD signed Date and time |
| 27716-0 | Respiratory therapy treatment plan, Date attending MD signed Date and time |
| 27767-3 | Medical social services treatment plan, Date attending MD signed Date and time |
| 29173-2 | Speech therapy treatment plan, Date attending MD signed Date and time |
| 52156-7 | Pulmonary therapy treatment plan, Date attending MD signed Date and time |