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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 NEXT QUESTIONNAIRE SECTION
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