| LP75255-7 | Nutritional approaches - none of above | COMPONENT | 1 |
| LP75256-5 | Nutritional approaches (quarterly RUG-III) | COMPONENT | 1 |
| LP75257-3 | Nutritional approaches (quarterly) | COMPONENT | 1 |
| LP75258-1 | Nutritional problems | COMPONENT | 1 |
| LP75259-9 | Nutritional problems - none of above | COMPONENT | 1 |
| LP7526-9 | Pulmonic valve regurgitant jet | SYSTEM | 1 |
| LP75260-7 | Nutritional status trigger | COMPONENT | 1 |
| LP75261-5 | Observational Assessment of Cognitive Status at 2 day Assessment Period | COMPONENT | 1 |
| LP75262-3 | Occasionally lift/carry | COMPONENT | 1 |
| LP75263-1 | Olfactory alteration | COMPONENT | 1 |
| LP75264-9 | Omaha System 2005 panel | COMPONENT | 1 |
| LP75265-6 | On a planned weight change program | COMPONENT | 1 |
| LP75266-4 | One or more foot problems | COMPONENT | 1 |
| LP75267-2 | One or more unhealed pressure ulcer(s) at stage 2 or higher | COMPONENT | 1 |
| LP75268-0 | One step (curb) during two day assessment period | COMPONENT | 1 |
| LP75269-8 | Open lesions on the foot | COMPONENT | 1 |
| LP7527-7 | Pus | SYSTEM | 10 |
| LP75270-6 | Open lesions other than ulcers, rashes, cuts | COMPONENT | 1 |
| LP75271-4 | Openly expresses conflict/anger with family/friends | COMPONENT | 1 |
| LP75272-2 | Oral and nutritional status section | COMPONENT | 1 |
| LP75273-0 | Oral hygiene during 2 day assessment period | COMPONENT | 1 |
| LP75274-8 | Oral mucous membranes impairment | COMPONENT | 1 |
| LP75275-5 | Oral or dental status section | COMPONENT | 1 |
| LP75276-3 | Oral problems | COMPONENT | 1 |
| LP75277-1 | Oral problems - none of above | COMPONENT | 1 |
| LP75278-9 | Oral problems (quarterly RUG-II) | COMPONENT | 1 |
| LP75279-7 | Oral status and disease prevention | COMPONENT | 1 |
| LP7528-5 | Race | SYSTEM | 2 |
| LP75280-5 | Oral status/disease prevention - none of above | COMPONENT | 1 |
| LP75281-3 | Ordered therapies | COMPONENT | 2 |
| LP75282-1 | Original or corrected copy of form | COMPONENT | 1 |
| LP75283-9 | Osteoporosis | COMPONENT | 1 |
| LP75284-7 | Ostomy care | COMPONENT | 1 |
| LP75285-4 | Ostomy for bowel elimination | COMPONENT | 1 |
| LP75286-2 | Ostomy present | COMPONENT | 1 |
| LP75287-0 | Other | COMPONENT | 1 |
| LP75288-8 | Other alleged impairments | COMPONENT | 1 |
| LP75289-6 | Other cardiovascular disease | COMPONENT | 1 |
| LP7529-3 | Radial artery | SYSTEM | 3 |
| LP75290-4 | Other current diagnoses and ICD9 codes (quarterly) | COMPONENT | 1 |
| LP75291-2 | Other current or more detailed diagnoses and ICD9 codes | COMPONENT | 2 |
| LP75292-0 | Other Diagnoses, Comorbidities, and Complications | COMPONENT | 1 |
| LP75293-8 | Other diagnosis 1 - ICD code | COMPONENT | 1 |
| LP75294-6 | Other diagnosis 1 - severity rating | COMPONENT | 1 |
| LP75295-3 | Other diagnosis 2 - ICD code | COMPONENT | 1 |
| LP75296-1 | Other diagnosis 2 - severity rating | COMPONENT | 1 |
| LP75297-9 | Other diagnosis 3 - ICD code | COMPONENT | 1 |
| LP75298-7 | Other diagnosis 3 - severity rating | COMPONENT | 1 |
| LP75299-5 | Other diagnosis 4 - ICD code | COMPONENT | 1 |
| LP7530-1 | Radial artery Left | SYSTEM | 5 |