A0100

Facility Provider Numbers

x Applies ›

A0200

Type of Provider

x Applies ›

A0500

Legal Name of Resident

x Applies ›

A0600

Social Security and Medicare Numbers

x Applies ›

A0700

Medicaid Number

x Applies ›

A0810

Sex

x Applies ›

A0900

Birth Date

x Applies ›