The DA 2985 form, pivotal in its role, serves as a comprehensive medical and administrative document used within the United States Army's healthcare system. This form meticulously records a wide range of admission and coding information necessary for treating military personnel. It encompasses details such as the reporting Medical Treatment Facility (MTF) and its location, the patient's register number, name, pay grade, and demographic information including sex, date of birth, age at admission, and race among others. Critical to the healthcare and administrative process, it also includes the length of service, social security number, marital status, military occupation specialties (MOS), and details about the beneficiary category. Moreover, the form addresses clinical and procedural data, spanning diagnoses, procedures, and medical disposition. This documentation is fundamental in ensuring that military personnel receive appropriate, timely, and coordinated care, and supports the broader healthcare administration within military facilities. It also plays a crucial role in coding for healthcare management, including tracking the types of illnesses and injuries treated within the military system, which can be essential for public health assessments and resource allocation. Given its comprehensive nature, the DA 2985 form is an indispensable tool in the operation of military healthcare facilities, contributing to the efficient management of patient care and administrative tasks.
Question | Answer |
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Form Name | Da Form 2985 |
Form Length | 3 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 45 sec |
Other names | da, 2985, APD, v1 |
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REPORTING MTF |
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MTF LOCATION |
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(State or |
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ADMISSION AND CODING INFORMATION |
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Code.) |
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3. |
REGISTER NUMBER |
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NAME (Last, First, Middle Initial) |
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4. PAY GRADE |
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6. DATE OF BIRTH (Y Y Y Y M M D D) |
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7. |
AGE AT ADMISSION |
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RACE |
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ETHNIC |
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RELIGION |
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BACK- |
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GROUND |
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10. |
LENGTH OF SERVICE |
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11. |
FMP |
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12. |
SOCIAL SECURITY NUMBER |
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ORGANIZATION (Active Duty Only) |
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13. |
MARITAL STATUS |
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HOUR OF |
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BRANCH / CORPS |
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ADMISSION |
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14. |
FLYING STATUS |
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15. |
BENEFICIARY CATEGORY |
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16. ZIP CODE OF RESIDENCE |
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17. |
UNIT LOCATION (State or |
18. |
MOS |
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19. |
TRAUMA |
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PREV. ADMISSION |
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YEAR |
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20. SOURCE OF ADMISSION/ AUTHORITY FOR |
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NAME/RELATIONSHIP OF EMERGENCY ADDRESSEE |
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ADMISSION |
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ADDRESS OF EMERGENCY ADDRESSEE (Include ZIP Code) |
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NAME AND LOCATION OF MEDICAL TREATMENT FACILITY |
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TELEPHONE NUMBER OF EMERGENCY ADDRESSEE |
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21. |
TYPE OF DISPOSITION |
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22. |
MTF TRANSFERRED TO |
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23. DATE OF DISPOSITION (Y Y Y Y M M D D) |
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24. |
CLINIC SVC - ADMITTING |
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25. |
MTF TRANSFERRED FROM |
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26. |
DATE THIS ADMISSION (Y Y Y Y M M D D) |
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89 |
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90 |
91 |
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92 |
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93 |
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94 |
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95 |
96 |
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97 |
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98 |
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99 |
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100 |
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101 |
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102 |
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103 |
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104 |
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106 |
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27. |
LOCATION OF OCCURRENCE |
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28. MTF OF INITIAL ADMISSION |
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29. DATE INITIAL ADMISSION (Y Y Y Y M M D D) |
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(Battle Casualty Only) |
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107 |
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108 |
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109 |
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110 |
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111 |
112 |
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113 |
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114 |
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115 |
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116 |
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117 |
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118 |
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119 |
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120 |
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121 |
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122 |
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FOR LOCAL USE |
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ADMITTING OFFICER (Signature, as required) |
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SIGNATURE OF ADMITTING CLERK |
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DA FORM 2985, MAR 2000
EDITION OF MAR 89 IS OBSOLETE |
APD PE v1.02ES |
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ADMISSION AND CODING INFORMATION |
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30. |
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AGE AT DISP |
31. |
AUTOPSY |
32. UNDERLYING CAUSE |
33. |
RESIDUAL DISABILITY |
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34. |
DO NOT USE - DATA FILLER #1 |
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35. |
CAUSE OF INJURY |
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Y / N |
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OF DEATH / SEP |
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123 |
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124 |
125 |
126 |
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127 |
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128 |
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129 |
130 |
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131 |
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132 |
133 |
134 |
135 |
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136 |
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137 |
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138 |
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139 |
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140 |
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141 |
142 |
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36. |
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FIRST DIAGNOSIS (Principal Diagnosis) |
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37. |
SECOND DIAGNOSIS |
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38. |
THIRD DIAGNOSIS |
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143 |
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144 |
145 |
146 |
147 |
148 |
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149 |
150 |
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151 |
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152 |
153 |
154 |
155 |
156 |
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157 |
158 |
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159 |
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160 |
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161 |
162 |
163 |
1648 |
165 |
166 |
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39. |
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FOURTH DIAGNOSIS |
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40. |
FIFTH DIAGNOSIS |
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41. |
SIXTH DIAGNOSIS |
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167 |
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168 |
169 |
170 |
171 |
172 |
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173 |
174 |
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175 |
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176 |
177 |
178 |
179 |
180 |
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181 |
182 |
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183 |
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184 |
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185 |
186 |
187 |
188 |
189 |
190 |
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42. |
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SEVENTH DIAGNOSIS |
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43. |
EIGHTH DIAGNOSIS |
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191 |
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192 |
193 |
194 |
195 |
196 |
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197 |
198 |
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199 |
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200 |
201 |
202 |
203 |
204 |
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205 |
206 |
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44. |
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FIRST PROCEDURE (Principal Diagnosis) |
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45. |
SECOND PROCEDURE |
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46. |
THIRD PROCEDURE |
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207 |
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208 |
209 |
210 |
211 |
212 |
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213 |
214 |
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215 |
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216 |
217 |
218 |
219 |
220 |
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221 |
222 |
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223 |
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224 |
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225 |
226 |
227 |
228 |
229 |
230 |
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47. |
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FOURTH PROCEDURE |
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48. |
FIFTH PROCEDURE |
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49. |
SIXTH PROCEDURE |
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231 |
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232 |
233 |
234 |
235 |
236 |
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237 |
238 |
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239 |
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240 |
241 |
242 |
243 |
244 |
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245 |
246 |
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247 |
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248 |
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249 |
250 |
251 |
252 |
253 |
254 |
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50. |
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SEVENTH PROCEDURE |
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51. |
EIGHTH PROCEDURE |
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255 |
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256 |
257 |
258 |
259 |
260 |
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261 |
262 |
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263 |
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264 |
265 |
266 |
267 |
268 |
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269 |
270 |
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52. |
NUMBER OF DIAGNOSTIC FIELDS |
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53. |
NUMBER OF PROCEDURAL FIELDS |
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54. |
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PRIMARY PROVIDER |
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55. |
BLOOD USAGE |
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CONTAINING CODES |
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CONTAINING CODES |
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SPECIALTY CODE |
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Y / N |
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271 |
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272 |
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273 |
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274 |
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275 |
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276 |
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277 |
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278 |
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0 |
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0 |
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0 |
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0 |
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PAGE 2, DA FORM 2985, MAR 2000 |
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APD PE v1.02ES |
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ADMISSION AND CODING INFORMATION |
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REPORTING MTF |
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REGISTER NUMBER |
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A |
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56. |
TOTAL SICK DAYS (All Facilities) |
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57. |
BED DAYS THIS MTF |
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58. |
BED DAYS OTHER FED MTFS |
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59. |
BED DAYS CIV. HOSPITALS |
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60. |
BASSINET DAYS (Neonatal) |
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279 |
280 |
281 |
282 |
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283 |
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284 |
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285 |
286 |
287 |
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288 |
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289 |
290 |
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291 |
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292 |
293 |
294 |
295 |
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296 |
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297 |
298 |
299 |
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61. |
QUARTER DAYS |
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62. |
MEDICAL HOLDING DAYS |
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63. |
COOPERATIVE CARE DAYS |
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64. |
CONVALESCENT LEAVE DAYS |
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65. |
SUPPLEMENTAL CARE DAYS |
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300 |
301 |
302 |
303 |
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304 |
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305 |
306 |
307 |
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308 |
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309 |
310 |
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311 |
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312 |
313 |
314 |
315 |
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316 |
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317 |
318 |
319 |
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66. |
OTHER DAYS |
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67. |
TOTAL SICK DAYS - THIS MTF |
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68. |
BED DAYS - ICU |
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69. |
BED DAYS - ADMITTING |
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70. |
CLINIC SERVICE (Second) |
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CLINIC |
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320 |
321 |
322 |
323 |
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324 |
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325 |
326 |
327 |
328 |
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329 |
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330 |
331 |
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332 |
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333 |
334 |
335 |
336 |
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337 |
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338 |
339 |
340 |
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SERVICE |
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71. |
BED DAYS SECOND CLINIC SERVICE |
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72. |
CLINIC SERVICE (Third) |
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73. |
BED DAYS THIRD CLINIC SERVICE |
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74. |
CLINIC SERVICE DISPOSITION |
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75. |
BED DAYS DISPOSITION CLINIC |
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SERVICE |
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341 |
342 |
343 |
344 |
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345 |
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346 |
347 |
348 |
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349 |
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350 |
351 |
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352 |
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353 |
354 |
355 |
356 |
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357 |
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358 |
359 |
360 |
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76. |
CONVALESCENT LEAVE RECOM- |
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77. |
PATIENT ACUITY - DAYS I |
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78. |
PATIENT ACUITY - DAYS II |
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79. |
PATIENT ACUITY - DAYS III |
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80. |
PATIENT ACUITY - DAYS IV |
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MENDED |
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361 |
362 |
363 |
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364 |
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365 |
366 |
367 |
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368 |
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369 |
370 |
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371 |
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372 |
373 |
374 |
375 |
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376 |
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377 |
378 |
379 |
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81. |
PATIENT ACUITY - DAYS V |
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82. |
PATIENT ACUITY - DAYS VI |
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83. |
DO NOT USE THIS SPACE |
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84. |
TYPE RECORD |
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380 |
381 |
382 |
383 |
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384 |
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385 |
386 |
387 |
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388 |
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389 |
390 |
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391 |
392 |
393 |
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394 |
395 |
396 |
397 |
398 |
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399 |
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FOR LOCAL USE |
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PAGE 3, DA FORM 2985, MAR 2000 |
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APD PE v1.02ES |
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