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45 Cards in this Set

  • Front
  • Back
Treatment Record is color coded, based on what number in sponsors SSN?
Second to last digit
Identify color of Treatment record based on last four digits of SSN.
2100
Orange "0" series
Identify color of Treatment record based on last four digits of SSN.
2110
Green "1" series
Identify color of Treatment record based on last four digits of SSN.
2120
Yellow "2" series
Identify color of Treatment record based on last four digits of SSN.
2130
Gray "3" Series
Identify color of Treatment record based on last four digits of SSN.
2140
Mustard "4" series
Identify color of Treatment record based on last four digits of SSN.
2150
Blue "5" series
Identify color of Treatment record based on last four digits of SSN.
2160
white "6" series
Identify color of Treatment record based on last four digits of SSN.
2170
Brown "7" series
Identify color of Treatment record based on last four digits of SSN.
2180
Pink "8" series
Identify color of Treatment record based on last four digits of SSN
2190
Red "9" series
Identify the family prefix on the Treatment Record.
"20"
Sponsor
Identify the family prefix on the Treatment Record.
"30"
Spouse
Identify the family prefix on the Treatment Record.
"31"
Second Spouse
Identify the family prefix on the Treatment Record.
"01"
First Child
Identify the family prefix on the Treatment Record.
"02"
Second Child
The 4 parts of a Health Record are:
"Part 1"
Preventive Medicine, Occupational Health,
Inpatient documentation
The 4 parts of a Health Record are:
"Part 2"
Medical Care Treatment(e.g. SF600,SF588,SF88,SF507, and SF93)
The 4 parts of a Health Record are:
"Part 3"
Physical Qualifications& Profiles
The 4 parts of a Health Record are:
"part 4"
Ancillary Studies(e.g X-rays,labs,advanced directives)
Health Records of the Individual? True/False?
False, property of the United States Government.
DD Form 2766 is what in the medical record?
Record of Ambulatory Care(ex. medical,conditions,allergies,meds,counseling,Hospitalizations)
SF 601 or DD Form 2766C is what in the medical record?
Immunization Record
DD Form 2796 is what in the medical record?
Post-Deployment Health Assessment
DD Form 2569 is what in the medical record?
Third Party Collection Program
AF form 1480 is what in the medical record?
Summary of Care
AF Form 565 is what in the medical record?
Record of Inpatient Treatment
SF 502 is what in the medical record?
Narrative Summary
SF 509 is what in the medical record?
Progress Note
NAVMED 6000/2 is what in the medical record?
Chronological Record of HIV Testing
DD Form 2215 is what in the medical record?
Baseline Audio-gram
SF 558 is what in the medical record?
Emergency Care and Treatment
SF 507 is what in the medical record?
Medical Record Continuation
SF 513 is what in the medical record?
Consultation Sheet(Refer PT to specialist for exam/procedure)
SF 88 or DD Form 2808 is what in the medical record?
Report of Medical Examination (completed BY PROVIDER upon entry of military service, special purposes, discharge, retirement)
SF 93 or DD Form 2807-01 is what in the medical record?
Report if Medial History (completed BY PATIENT upon entry of military service, discharge, when physical examination required)
NAVMED 6150/4 is what in the medical record?
Abstract of Service and Medical History
OPNAV 5211/9 is what in the medical record?
Record of Disclosure (As required by Privacy act of 1974)
DD Form 2005 is what in the medical record?
Privacy Act Statement Health Care Record (Inform pt of Privacy rights)
AF Form 348 is what in the medical record?
Line of Duty Determination
AF Form 422 is what in the medical record?
Physical Profile Serial Report
SF 519 is what in the medical record?
Radio-logic Consultation Request/Reports
(backing sheet for mounting X-Ray, MRI,CT,SF519A reports)
SF 545 is what in the medical record?
Laboratory Report Display (backing sheet for mounting lab reports)
DD Form 877 is what in the medical record?
Request for Medical/Dental Records or Information
SF 602 is what in the medical record?
Health Records-Lab Results