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Get Epsdt-pcs 90 2010

C Resp distress Vision impairment (1 2 3 ) Hypotonia No (1 2 3 ) (1 2 3 ) 2 3) III. LEVEL OF CARE DETERMINATION Activities of Daily Living: Based on the recipient’s impairment, the attending physician should check the appropriate box as it applies to the recipient’s ability to perform this age appropriate tasks using the following definitions and PCS Level of Assistance Guide: Not Independent at this Age – not age appropriate to perform this task independently Independent – recipi.

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