DD_DIA_CMS_START

Description: |
This table contains data elements submitted for CMS ESRD patient registration forms (CMS-2728).

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
REGISTRY_DATA_ID | 1 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | REGISTRY_DATA_ID | NUMERIC | No |
The unique identifier for the registry data record.
2 | FORM_IDENTIFIER | VARCHAR | No |
The CMS 2728 form identifier.
3 | DLYS_REG_FORM_TYPE_C_NAME | VARCHAR | No |
The CMS 2728 form type, such as initial registration or reentitlement.
May contain organization-specific values: Yes
Category Entries:
Initial Dialysis
Reentitlement Restart Dialysis
Reentitlement Dialysis After Transplant Failed
Supplemental Training
4 | ADMISSION_DEPARTMENT_ID_EXTERNAL_NAME | VARCHAR | No |
The external name of the department record. This is often used in patient correspondence such as reminder letters.
5 | PAT_FIRST_NAME | VARCHAR | No |
The patient's first name.
6 | PAT_MIDDLE_INITIAL | VARCHAR | No |
The patient's middle initial.
7 | PAT_LAST_NAME | VARCHAR | No |
The patient's last name.
8 | DLYS_NAME_SUFFIX_C_NAME | VARCHAR | No |
The patient's name suffix.
May contain organization-specific values: Yes
Category Entries:
Jr
Sr
II
III
IV
V
VI
9 | DLYS_PAT_SEX_C_NAME | VARCHAR | No |
The patient's sex assigned at birth.
May contain organization-specific values: No
Category Entries:
F
M
10 | PAT_BIRTH_DATE | DATETIME | No |
The patient's date of birth.
11 | PAT_HICNUM | VARCHAR | No |
The patient's Medicare health insurance claim number.
12 | PAT_MBI_NUM | VARCHAR | No |
The patient's Medicare Beneficiary Identifier number.
13 | PAT_SSN | VARCHAR | No |
The patient's Social Security number.
14 | MAIL_ADDRESS_STREET_1 | VARCHAR | No |
The first line of the street address of the patient's mailing address.
15 | MAIL_ADDRESS_STREET_2 | VARCHAR | No |
The second line of the street address of the patient's mailing address.
16 | MAIL_ADDRESS_CITY | VARCHAR | No |
The city of the patient's mailing address.
17 | MAIL_ADDRESS_TAX_STATE_C_NAME | VARCHAR | No |
The state of the patient's mailing address.
May contain organization-specific values: Yes
18 | MAIL_ADDRESS_COUNTY_2_C_NAME | VARCHAR | No |
The county of the patient's mailing address.
May contain organization-specific values: Yes
19 | MAIL_ADDRESS_ZIP_EXT | VARCHAR | No |
The ZIP code extension of the patient's mailing address.
20 | PHONE_AREA_CODE | NUMERIC | No |
The area code of the patient's phone number.
21 | PHONE_NUMBER | VARCHAR | No |
The patient's phone number, minus the area code.
22 | DLYS_PAT_CNTRY_OF_ORG_C_NAME | VARCHAR | No |
The patient's country of origin.
May contain organization-specific values: No
Category Entries:
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of (North Korea)
Korea, Republic of (South Korea)
Kuwait
Kyrgyzstan
Lao People's Democratic Republic (Laos)
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya (Libya)
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and The Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
Great Britain
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
23 | DLYS_PAT_ETHNICITY_C_NAME | VARCHAR | No |
The patient's ethnicity.
May contain organization-specific values: Yes
Category Entries:
Non-Hispanic or Latino
Hispanic or Latino
24 | PAT_TRIBE_CODE | NUMERIC | No |
This column has been replaced by DIA_PAT_TRIBE_C (RDI/28584) in table DD_DIA_CMS_START. To look up the deprecated column's value after the Clarity Compass upgrade, join column DD_DIA_CMS_START.DIA_PAT_TRIBE_C to table ZC_PAT_TRIBE column PAT_TRIBE_C and get the TITLE value.
25 | DLYS_ETH_SELF_REP_C_NAME | VARCHAR | No |
Whether the patient's race and ethnicity were self-reported.
May contain organization-specific values: No
Category Entries:
Self Reported
Not Self Reported
Family Reported
Patient Declined
26 | ESRD_MEDICARE_APPLY_YN | VARCHAR | No |
Whether the patient is applying for end stage renal disease Medicare coverage.
May contain organization-specific values: No
Category Entries:
No
Yes
27 | PRIOR_DLYS_EMPY_STATUS_C_NAME | VARCHAR | No |
The patient's employment status six months prior to renal failure.
May contain organization-specific values: No
Category Entries:
Unemployed
Full-Time
Part-Time
Homemaker
Retired Due to Age/Preference
Retired Due to Disability
Medical Leave
Student
Volunteer
28 | CURRENT_DLYS_EMPY_STATUS_C_NAME | VARCHAR | No |
The patient's current employment status.
The category values for this column were already listed for column: PRIOR_DLYS_EMPY_STATUS_C_NAME
29 | PAT_HEIGHT | NUMERIC | No |
The patient's height.
30 | DLYS_HEIGHT_UNIT_C_NAME | VARCHAR | No |
The unit used for the patient's height.
May contain organization-specific values: Yes
Category Entries:
Inch
Centimeter
31 | PAT_DRY_WEIGHT | NUMERIC | No |
The patient's dry weight.
32 | DLYS_WEIGHT_UNIT_C_NAME | VARCHAR | No |
The unit used for the patient's weight.
May contain organization-specific values: Yes
Category Entries:
Pound
Kilogram
33 | DIA_CMS_GFR_METHOD_C_NAME | VARCHAR | No |
The method used to calculate the patient's glomerular filtration rate (GFR).
May contain organization-specific values: Yes
Category Entries:
MDRD
IDMS
OMDRD
BIDMS
34 | PRIM_CAUSE_RENAL_FAIL_DX_ID_DX_NAME | VARCHAR | No |
The name of the diagnosis.
35 | EPO_RECEIVED_DIA_CMS_YNU_C_NAME | VARCHAR | No |
Whether the patient received exogenous erythropoietin (EPO) or equivalent prior to end stage renal disease therapy.
May contain organization-specific values: Yes
Category Entries:
Yes
No
Unknown
36 | EPO_DIA_CMS_DATE_RANGE_C_NAME | VARCHAR | No |
The time range in which exogenous erythropoietin (EPO) or equivalent was administered to the patient prior to end stage renal disease therapy.
May contain organization-specific values: No
Category Entries:
Less Than 6 Months
6-12 Months
Greater Than 12 Months
37 | NEPH_CARE_RECV_DIA_CMS_YNU_C_NAME | VARCHAR | No |
Whether the patient was under nephrologist care before starting end stage renal disease therapy.
The category values for this column were already listed for column: EPO_RECEIVED_DIA_CMS_YNU_C_NAME
38 | NEPH_CARE_DIA_CMS_DATE_RANGE_C_NAME | VARCHAR | No |
The time range in which the patient was under nephrologist care prior to end stage renal disease therapy.
The category values for this column were already listed for column: EPO_DIA_CMS_DATE_RANGE_C_NAME
39 | DIET_CARE_RECV_DIA_CMS_YNU_C_NAME | VARCHAR | No |
Whether the patient was under kidney dietician care prior to end stage renal disease therapy.
The category values for this column were already listed for column: EPO_RECEIVED_DIA_CMS_YNU_C_NAME
40 | DIET_CARE_DIA_CMS_DATE_RANGE_C_NAME | VARCHAR | No |
The time range in which the patient was under kidney dietician care prior to end stage renal disease therapy.
The category values for this column were already listed for column: EPO_DIA_CMS_DATE_RANGE_C_NAME
41 | DIA_CMS_FIRST_ACCESS_C_NAME | VARCHAR | No |
The type of access used for the first outpatient dialysis treatment prior to end stage renal disease therapy.
May contain organization-specific values: Yes
Category Entries:
AVF
Graft
Catheter
Other
PD Catheter
Central Venous Catheter
42 | MATURE_AVF_PRESENT_YN | VARCHAR | No |
Whether the patient had a maturing arteriovenous fistula (AVF) present prior to end stage renal disease therapy.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
43 | MATURE_AVG_PRESENT_YN | VARCHAR | No |
Whether the patient had a maturing arteriovenous graft (AVG) present prior to end stage renal disease therapy.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
44 | DLYS_TRT_LOCATION_C_NAME | VARCHAR | No |
The primary setting in which the patient receives dialysis treatment, such as the patient's home, a dialysis treatment center, skilled nursing facility, or long-term care facility.
May contain organization-specific values: Yes
Category Entries:
Home
Dialysis Facility/Center
SNF/Long Term Care Facility
45 | DLYS_TRT_TYPE_C_NAME | VARCHAR | No |
The type of dialysis treatment the patient receives, e.g. hemodialysis or peritoneal dialysis.
May contain organization-specific values: Yes
Category Entries:
Hemodialysis
CAPD
CCPD
Other
46 | DIALYSIS_SESSIONS_PER_WEEK | NUMERIC | No |
The number of hemodialysis sessions per week prescribed for the patient.
47 | DIALYSIS_SESSION_LENGTH_HOURS | NUMERIC | No |
The duration, in hours, of hemodialysis sessions prescribed for the patient.
48 | CHRONIC_DIALYSIS_START_DATE | DATETIME | No |
The date the patient began a regular course of dialysis treatments.
49 | FACILITY_TREATMENT_START_DATE | DATETIME | No |
The date the patient began receiving dialysis treatments at the current facility.
50 | TXP_OPTIONS_PROVIDED_YN | VARCHAR | No |
Whether the patient has been informed of their options for receiving a kidney transplant.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
51 | ATTENDING_PROV_ID_PROV_NAME | VARCHAR | No |
The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table.
52 | ATTENDING_PROV_REMARKS | VARCHAR | No |
Miscellaneous remarks entered by the patient's attending provider.
53 | LAB_ALBUMIN_VALUE | NUMERIC | No |
The patient's serum albumin lab value.
54 | LAB_ALBUMIN_DATE | DATETIME | No |
The patient's serum albumin lab collection date.
55 | LAB_ALBUMIN_LOWER_LIMIT | NUMERIC | No |
The patient's serum albumin lab lower limit value.
56 | LAB_ALBUMIN_METHOD_C_NAME | VARCHAR | No |
The patient's serum albumin lab method.
May contain organization-specific values: Yes
Category Entries:
BCG
BCP
57 | LAB_CREATININE_VALUE | NUMERIC | No |
The patient's serum creatinine lab value.
58 | LAB_CREATININE_DATE | DATETIME | No |
The patient's serum creatinine lab collection date.
59 | LAB_HEMOGLOBIN_VALUE | NUMERIC | No |
The patient's hemoglobin lab value.
60 | LAB_HEMOGLOBIN_DATE | DATETIME | No |
The patient's hemoglobin lab collection date.
61 | LAB_HBA1C_VALUE | NUMERIC | No |
The patient's glycated hemoglobin (HbA1c) lab value that was collected within 45 days prior to the first dialysis treatment or kidney transplant (whichever is more recent).
62 | LAB_HBA1C_DATE | DATETIME | No |
The patient's glycated hemoglobin (HbA1C) lab date that was collected within 45 days prior to the first dialysis treatment or kidney transplant (whichever is more recent).
63 | LAB_LIPID_TC_VALUE | NUMERIC | No |
The patient's lipid profile total cholesterol lab value that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
64 | LAB_LIPID_TC_DATE | DATETIME | No |
The patient's lipid profile total cholesterol lab date that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
65 | LAB_LIPID_LDL_VALUE | NUMERIC | No |
The patient's lipid profile LDL cholesterol lab value that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
66 | LAB_LIPID_LDL_DATE | DATETIME | No |
The patient's lipid profile LDL cholesterol lab date that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
67 | LAB_LIPID_HDL_VALUE | NUMERIC | No |
The patient's lipid profile HDL cholesterol lab value that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
68 | LAB_LIPID_HDL_DATE | DATETIME | No |
The patient's lipid profile HDL cholesterol lab date that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
69 | LAB_LIPID_TRIGLYCERIDES_VALUE | NUMERIC | No |
The patient's lipid profile triglyceride lab value that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
70 | LAB_LIPID_TRIGLYCERIDES_DATE | DATETIME | No |
The patient's lipid profile triglyceride lab date that was collected within one year prior to the first dialysis treatment or kidney transplant (whichever is more recent).
71 | TRAINING_DEPARTMENT_ID_EXTERNAL_NAME | VARCHAR | No |
The external name of the department record. This is often used in patient correspondence such as reminder letters.
72 | TRAINING_START_DATE | DATETIME | No |
The start date for the patient's dialysis training.
73 | TRAINING_END_DATE | DATETIME | No |
The end date for the patient's dialysis training.
74 | TRAINING_DLYS_TRT_TYPE_C_NAME | VARCHAR | No |
The type of training given to a patient in preparation for dialysis treatment.
The category values for this column were already listed for column: DLYS_TRT_TYPE_C_NAME
75 | DLYS_SELFCARE_STATUS_C_NAME | VARCHAR | No |
Whether the patient is expected to perform self-care at home or in-center after dialysis training.
May contain organization-specific values: No
Category Entries:
Home
Incenter
76 | SELF_DIALYZE_YN | VARCHAR | No |
Whether the patient will self-dialyze after completing dialysis training.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
77 | TRAINING_PROV_ID_PROV_NAME | VARCHAR | No |
The name of the service provider. This item may be hidden in a public view of the CLARITY_SER table.
78 | MAIL_ADDRESS_ZIP | VARCHAR | No |
The ZIP code of the patient's mailing address.
79 | PAT_NO_SIGN_REASON_C_NAME | VARCHAR | No |
The dialysis patient unable to sign reasons category ID for the CMS Form 2728 abstraction.
May contain organization-specific values: No
Category Entries:
LostToFollowUp
MoveOut
Expired
80 | PAT_DEATH_DATE | DATETIME | No |
The date when a dialysis patient died.
81 | PRIOR_LAB_VALUES_C_NAME | VARCHAR | No |
The time period when labs were collected for CMS Form 2728 for the abstraction.
May contain organization-specific values: Yes
Category Entries:
Prior Lab Values (Within 45 days prior to the date chronic dialysis began)
Admission Lab Values (Within 15 days before or after the facility treatment start date)
82 | LAB_CYSTATIN_C_VALUE | NUMERIC | No |
The patient's Cystatin C lab value.
83 | LAB_CYSTATIN_C_DATE | DATETIME | No |
The patient's Cystatin C lab collection date.
84 | FIRST_ACSS_CVC_USED_YN | VARCHAR | No |
Indicates whether one lumen of the central venous catheter was used and one needle was placed in an AVF or graft. 'Y' indicates that one lumen of the central venous catheter was used and one needle was placed in an AVF or graft. 'N' or NULL indicates that a central venous catheter is not present or was not used.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
85 | FIRST_ACSS_PD_CATH_USED_YN | VARCHAR | No |
Indicates whether the peritoneal dialysis catheter was present during the patient's first chronic dialysis treatment. 'Y' indicates that the peritoneal dialysis catheter was present. 'N' or NULL indicates that a peritoneal dialysis catheter was not present.
The category values for this column were already listed for column: ESRD_MEDICARE_APPLY_YN
86 | DIA_PAT_TRIBE_C_NAME | VARCHAR | No |
The dialysis patient tribe category ID for the registry data.
May contain organization-specific values: Yes
Category Entries:
Non-Indian
Alaskan Indian
Aleut
Eskimo
Apache
Apache, Ft. Sill
Apache, Jicarilla
Apache-Kiowa
Apache, Mescalero
Apache, Yavapai
Arikara
Arapahoe
Arapahoe-Cheyenne
Assiniboine
Bannock
Blackfeet
Caddo
Canadian Indian
Cayuga
Cayuga-Seneca
Chehalis, Confederated Tribes
Chemehuevi
Cherokee
Cherokk (Eastern Bank)
Cherokee-Shawnee
Cherokee-Delaware
Cheyenne
Chickasaw
Chinook
Chinook (Landless)
Chippewa (Ojibway)
Choctaw
Choctaw (Mississippi Band)
Chumask
Clallam
Cahuilla
Cocopah
Coeur Dalene
Colville
Comanche
Cowlitz
Cowlitz (Landless)
Cree
Creek
Crow
Dakota (Sioux)
Delaware of Western Oklahoma
Dieguenc
Dwamish
Flathead
Gros Ventre, Hidatsa, Minitaki
Havasupai
Hoh Band
Hoopa
Hopi
Hualapai
Iowa
Iowa of Kansas
Kaw
Kickapoo
Kickapoo of Kansas
Kickaillus
Kiowa
Kootenai Band
Humptulips
Capalis
Satsop
Wynnoche
Luiseno
Lummi
Maidu
Makah
Mandan
Maricopa
Menominee
Me-Wuk
Miami
Miccosukee of Florida
Missouri
Otoe-Missouri
Modoc
Mohave
Muckleshoot
Munsee
Navajo
Nez Perce
Nisqually
Nomelacki
Nooksack
Omaha
Oneida
Osage
Otoe
Ottawa
Ozette
Paiute
Tohono
Pawnee
Pima
Pit River
Pojoaque
Pomo
Ponca
Potawatomie
Potawatomie (Citizen Band)
Potawatomie (Kansas Prairie Band)
Puyallup
Acoma
Cochiti
Isleta
Jemez
Laguna
Nambe
Picuris
Sandia
San Felipe
San Idlefonso
San Juan
Santa Ana
Santa Clara
Santa Domingo
Taos
Tesuque
Zia
Zuni
Quapaw
Quechan
Quilleute
Quinault
Sac + Fox
Sac + Fox of Oklahoma
Sac + Fox of Kansas + Neb
Samish
San Juan of Washington
Sauk-Suiattle
Seminole
Seminole of Florida
Seminole of Oklahoma
Seneca
Serrano
Shawnee
Shawnee, Absentee
Shawnee, Eastern
Shoshone
Skagit, Lower
Skagit, Upper
Skokomish
Skykomish
Snohomish
Snohomish (Landless)
Snoqualimie
Ute, Southern
Spokane
Squaxin Island
Steilacoom
Stilaquamish
Stockbridges
Suquamish
Swinomish
Tachi
Te-Moak
Tunkawa
Tule River
Tulalip
Umatilla, Confederated Tribes of
Ute
Ute, Mountain
Wailaki
Warm Springs, Confederated Tribes of
Washoe
Wichita
Winnebago
Wintun
Wyandot
Yakima
Yavapai
Yuchi
Yuki
Yurok
Kalispel
Chitimacha
Coushatta
St. Regis Mohawk
Siletz
Peoria
Shoalwater
Wea
Pascua Yaqui
Passamaquoddy (Pleasant Pt.)
Passamaquoddy (Indian Township)
Penobscot
Narraganset
Tonawanda
Arrostook (Indian Association)
Paiute of Utah
Tuscarora Nation of New York
Grand Traverse Chippewa-Ottawa
Pasqua Yaqui - Unenrolled
Cow Creek of Umpqua-Oregon
Kickapoo of Texas
Goshute
Miwock
Wampanoag
Tunica-Biloxi
Houlton Band (Malisetts)
Tewa
Pequot
Poarch Creeks
Grand Ronde
Shoshone-Bannock
Tlingit
Tolowa/Tolowa-Hoopa
Confederated Tribes of Coos-Oregon
Klallam - Lower Elwha
Klallam - Port Gamble
Celilo-Wyam Board
Karuk (California)
Onondaga Nation of New York
Mission (California)
Quartz Valley Ranch
Northwest Bank, Shoshone, Utah
Klamath
Ysleta Del Sur Pueblo
Alabama & Coushatta Tribes of Texas
Shinnecock
Lumbee
EBCI (Eastern Band of Cherokee Indians)
Tonto Apache Tribe of Arizona
Apache Tribe of Oklahoma
San Carlos Apache - Arizona
Whitemountain Apache - Arizona
Ft. McDowell Mohave-Apache-Arizona
Assiniboine & Sioux - Montana
Ft. Belknap-Assiniboine-Montana
United Keetooway-Cherokee-Oklahoma
Keweenaw Bay-Chippewa-Michigan
Bad River Band-Chippewa Wisconsin
Bay Mills-Chippewa-Minnesota
Saginaw Chippewa - Michigan
Lac Du Flambeau-Chippewa-Wisconsin
Red Cliff-Chippewa-Wisconsin
Red Lake-Chippewa-Minnesota
Sault Ste.Marie-Chippewa-MI
Sokoagon-Chippewa-Wisconsin
St. Croix-Chippewa-Wisconsin
Turtle Mountain-Chippewa-Wisconsin
Augustine-Cahuilla Mission-California
Cabazon-Cahuilla Mission-California
Cahuilla Mission-California
Lus Coyotes-Cahuilla Mission-California
Morongo-Cahuilla Mission-California
Ramona-Cahuilla Mission-California
Santa Rosa-Santa Rosa Ranch-California
Tores-Martinez-Chuilla Mission-California
Aqua-Caliente-Cahuilla-California
Alabama-Quassarte-Creek-Oklahoma
Kialegee-Creek-Oklahoma
Thlopthlocco-Creek-Oklahoma
Col.River Indians-Arizona & California
Devils Lake Sioux - North Dakota
Prairie Island-Sioux-Minnesota
Snakopee Mdewakanton-Sioux-Minnesota
Yankton Sioux - South Dakota
Assiniboine/Sioux - Montana
Cheyenne River Sioux - South Dakota
Crow Creek Sioux - South Dakota
Flandreau Santee Sioux - South Dakota
Lower Brule Sioux - South Dakota
Lower Sioux - Minnesota
Oglala Sioux-Pine Ridge - South Dakota
Rosebud Sioux - South Dakota
Santee Sioux - Nebraska
Sisseton-Wahpeton Sioux - South Dakota
Standing Rock Sioux - North/South Dakota
Upper Sioux - Minnesota
Fort Belknap-Gros Ventre - Montana
Three Affil. Trives - Gros Ventre
Gilla River Pima Marcopo - Arizona
Oneida - Wisconsin
Wisconsin Winnebago - Wisconsin
La Jojja-Luiseno Mission - California
Pala Band-Luiseno Mission - California
Pauma Band-Luiseno Mission - California
Pechanga Band-Luiseno Mission - California
Rincon Band-Luiseno Mission - California
Soboba Band-Luiseno Mission - California
Twenty-Nine Palms-Luiseno - California
Berry Creek Ranch - Maidu - California
Enterprise Ranch - Maidu - California
Greenville Ranch - Maidu - California
Mooretown Ranch - Maidu - California
Buena Vista Ranch - Mewuk - California
Chicken Ranch Ranch - Mewuk - California
Jackson Ranch - Mewuk - California
Sheep Ranch Ranch - Mewuk - California
Toolumne - Mewuk - California
Barona Capitan Grande-Dieg-California
Campo Band-Diegueno - California
Capitan Grande-Diegueno - California
Cuyhapaipe-Diegueno Mission - California
La Posta Band-Diegueno Mssion - California
Manzanita-Diegueno Mission - California
Mesa Grande Band-Diegueno - California
San Pasqual-Diegueno - California
Santa Ysabel-Diegueno - California
Sycuan-Diegueno Mission - California
Viejas Baron Long Capt.Grande - California
Bridgeport Paiute Colony - California
Cedarville Ranch.North.Paite - California
Ft. Bidwell-Paiute - California
Ft. Independence-Paiute - California
Reno-Sparks Colony-Paiute - Nevada
Utu Utu Gwaiti - Paiute - California
Burns Paiute Colony - Oregon
Kaibab Band - Paiute - Arizona
Las Vegas - Paiute - Nevada
Lovelock - Paiute - Nevada
Moapa Band - Paiute - Nevada
Pyramid Lake - Paiute - Nevada
Summit Lake - Paiute - Nevada
Walker River - Paiute - Nevada
Yerington - Paiute - Nevada
Ak Chin Indian Comm.-Papago - Arizona
Big Pine Band - Paiute - California
Ft. McDermitt-Paiute/Shoshone - Nevada
Bishop - Paiute/Shoshone - California
Fallon - Paiute/Shoshone - Nevada
Lone Pine-Paiute/Shoshone - Nevada
Duck Valley-Paiute/Shoshone - Nevada
Duckwater Shoshone - Nevada
Death Valley Timbe-Sha/Shos - California
Reno-Sparks - Shoshone - Nevada
Shoshone - Wind River - Wyoming
Yumba - Shoshone - Nevada
Ely Indian Colony - Nevada
Winnemucca Indian Colony - Nevada
Skull Valley Band-Goshute-Liah
Salt River Pima-Maricopa - Arizona
Forest County Potawatchi - Wisconsin
Hannahville-Potawatomie - Michigan
Gib Bend Ranch.-Pit River - California
Lookout Ranch.-Pit River - California
Montgomery Creek Ranch-Pit - California
Pit River-X-L Ranch - California
Roaring Creek Ranch.Pit River - California
Alturas Ranch.-Pit River - California
Cloverdale Ranch.-Pit River - California
Coyote Valley-Pomo - California
Dry Creek Ranch.-Pomostewarts Pt-California
Elem.Indian Colony - Pomo - California
Kashia Band-Pomo-Stewarts Pt - California
Manchester Band-Pomo-Man.Pt. - California
Middletown Ranch.-Pomo - California
Pinoleville Ranch.-Pomo - California
Redding Ranch.-Pomo - California
Redwood Valley Ranch.-Pomo - California
Robinson Ranch.-Pomo - California
Sherwood Valley Ranch.-Pomo - California
Upper Lake Band-Pomo - California
Potter Valley Ranch.-Pomo - California
Hopland Band-Pomo - California
Chchil De He Band-Colusa - California
Cortina Ranch.-Wintun - California
Coast Community-Yurok - California
Yurok-Hoopa Valley - California
Barona Group-Capitan Grande - California
Viejas Group-Capitan Grande - California
Big Lagoon Ranch.-Smith River - California
Big Sandy Ranch.-Mono - California
Cold Springs Ranch.-Mono - California
Northfork Ranch.-Mono - California
Big Valley Ranch.-Pomo/Pit - California
Blue Lake Rancheria - California
Cherae Heights-Trinidad - California
Jamul Village of California
Picayune Ranch.-Chukchansi - California
Rohnerville Ranch.-Mattole - California
Santa Rosa-Cahuilla Mission - California
Shingle Springs-Miwok - California
Smith River Rancheria - California
Susanville Ranch - California
Table Bluff Ranch.-Wiyot - California
Table Mountain Ranch - California
Cahto-Laytonville Ranch - California
Inaja Band-Cosmit Mission - California
Grindstone-Wintun-Waitaki - California
Boise Forte Band-Chippewa - Minnesota
Fund Du Lac Band-Chippewa - Minnesota
Grand Portage Band-Chippewa - Minnesota
Leech Lake Band-Chippewa - Minnesota
Mille Lac Band - Chippewa - Minnesota
White Earth Band-Chippewa - Minnesota
Keweenaw Bay Comm.-Chippewa - Minnesota
Elk Valley Ranch.Smith River - California
Ahtna
Catawba
Ojibwa - North Dakota
Mohegan - Connecticut
Nanticoke Lenni-Lenape
Mohawk
Tejon
Chickahominy
Non-Indian Member Indian Household
Indian Non-Tribal Member
Mid-East Arabian
Chinese
Filipino
Indian subcontinent
Japanese
Korean
Chamorro
Hawaiian
Marshall Islands
Chuukese
Micronesian/Carolinian (Unspecified)
Yapese
Palauan
Pohnpean
Pacific Islander (not G, S, or H)
Samoan
Tongan