67871-4
Patient demographics - end stage renal disease form 2728
Trial
Status Information
- Status
- TRIAL
Panel Hierarchy
Details for each LOINC in Panel LHC-Forms
| LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
|---|---|---|---|---|
| 67871-4 | Patient demographics - end stage renal disease form 2728 | |||
| Indent56799-0 | Address | R | ||
| Indent68997-6 | Patient City (Mailing) | R | ||
| Indent46499-0 | State of residence | R | ||
| Indent45401-7 | Postal code [Location] | R | ||
| Indent42077-8 | Patient phone number | R | ||
| Indent46098-0 | Sex | R | ||
| Indent54133-4 | Ethnicity [USSG-FHT] | O | ||
| Indent68329-2 | Country of origin | C | ||
| Indent54134-2 | Race [USSG-FHT] | R | ||
| Indent67884-7 | Tribal enrollment | C | 0..* | |
| Indent67872-2 | Is the patient applying for ESRD Medicare coverage? | R | 1..* | |
| Indent52556-8 | Payment sources | |||
| Indent8302-2 | Body height | R | [in_us];cm;m | |
| Indent8340-2 | Dry body weight Estimated | R | kg;[lb_av] | |
| Indent67873-0 | Primary Cause of Renal Failure Code | C | ||
| Indent67874-8 | Patient Prior Employment Status (6 Months Prior) | R | ||
| Indent67875-5 | Patient Current Employment Status (At Onset) | R | ||
| Indent67876-3 | Co-Morbid Conditions | R | ||
| Indent67885-4 | Received exogenous erythropoetin or equivalent prior to end stage renal disease therapy | C | ||
| Indent67886-2 | Care by nephrologist prior to end stage renal disease therapy | C | ||
| Indent67887-0 | Care by kidney dietician prior to end stage renal disease therapy | C | ||
| Indent67888-8 | Access Type for First Outpatient Dialysis | C | ||
| Indent68449-8 | Is maturing AVF present? | C | ||
| Indent68450-6 | Is maturing graft present? | C |
Fully-Specified Name
- Component
- Patient demographics - end stage renal disease form 2728
- Property
- -
- Time
- Pt
- System
- ^Patient
- Scale
- -
- Method
Basic Attributes
- Class
- PANEL.SURVEY.ESRD
- Type
- Surveys
- First Released
- Version 2.38
- Last Updated
- Version 2.44 (MIN)
- Panel Type
- Panel
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 67868-0 | End Stage Renal Disease (ESRD) Medical Evidence Report, Medicare Entitlement AndOr Patient Registration - OMB CMS form 2728 |
LOINC Terminology Service (API) using HL7® FHIR® Get Info
Requests to this service require a free LOINC username and password. Below is a sample of the possible capabilities. See the LOINC Terminology Service documentation for more information.
- CodeSystem lookup
- https:
//fhir.loinc.org/CodeSystem/$lookup?system=http: //loinc.org&code=67871-4
LOINC Copyright
Copyright © 2025 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. See https://