Other Medical Expenses (OM) Section

BOX_01A

IF ROUND 3, CONTINUE WITH BOX_01B
OTHERWISE, GO TO BOX_01


BOX_01B
IF OM ITEM TYPE IS GLASSES/CONTACT LENSES,
CONTINUE WITH OM01A
OTHERWISE, GO TO BOX_01


OM01A

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}{END-DT}

Of the times (PERSON) obtained glasses or contact lenses since
(START DATE), how many were during {YEAR}?

NUMBER OF TIMES

[Enter Number of Times]................ {OM01B}
REF.................................... -7 {OM01B}
DK..................................... -8 {OM01B}
(FOR SPECIFICATIONS ONLY; CAPI HANDLES
AUTOMATICALLY): ‘YEAR’ IN QUESTION TEXT IS FIRST
CALENDAR YEAR OF PANEL.


OM01B

{PERSON'S FIRST MIDDLE AND LAST NAME} {STR-DT}{END-DT}

Of the times (PERSON) obtained glasses or contact lenses since
(START DATE), how many were during {YEAR}?

NUMBER OF TIMES

[Enter Number of Times]................
REF.................................... -7
DK..................................... -8
(FOR SPECIFICATIONS ONLY; CAPI HANDLES
AUTOMATICALLY): ‘YEAR’ IN QUESTION TEXT IS SECOND
CALENDAR YEAR OF PANEL.
IF THE CHARGE/PAYMENT (CP) SECTION HAS NOT BEEN
ASKED FOR THE EVENT BEING ASKED ABOUT, GO TO THE
CP SECTION.
OTHERWISE, GO TO THE EVENT DRIVER (ED) SECTION.


BOX_01
IF THE OM ITEM TYPE IS INSULIN OR OTHER DIABETIC
EQUIPMENT OR SUPPLIES, GO TO BOX_03
OTHERWISE, CONTINUE WITH BOX_02


OM01

OMITTED.


BOX_02
IF THE CHARGE/PAYMENT (CP) SECTION HAS NOT BEEN
ASKED FOR THE EVENT BEING ASKED ABOUT, GO TO THE
CP SECTION
OTHERWISE, GO TO THE EVENT DRIVER (ED) SECTION


OM02

OMITTED.


BOX_03
FLAG THE OM CHARGE/PAYMENT (CP) SECTION AS
‘PROCESSED’. INSULIN AND OTHER DIABETIC EQUIPMENT
AND SUPPLIES WILL BE PROCESSED THROUGH CP AS
PRESCRIBED MEDICINES.
GO TO BOX_04


BOX_04
GO TO THE EVENT DRIVER (ED) SECTION

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