|
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: |
InitialDialysis |
ReentitlementRestartDialysis |
ReentitlementDialysisAfterTransplantFailed |
SupplementalTraining |
|
|
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 |
|
|
|
|
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 |
|
|
|
The patient's tribe code. |
|
|
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: |
SelfReported |
NotSelfReported |
FamilyReported |
PatientDeclined |
|
|
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 |
FullTime |
PartTime |
Homemaker |
RetiredAgePref |
RetiredDisability |
MedicalLeave |
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 |
|
|
|
|
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: |
LessThan6Months |
6-12Months |
GreaterThan12Months |
|
|
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 |
|
|