Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

Medicare Current Beneficiary Survey (MCBS)

Attachment 4 English RostersSOPRoster0301_0000PopUpVars

Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

OMB: 0938-0568

Document [pdf]
Download: pdf | pdf
SOP Roster Pop-Up
Item #:

TSOPTEXT
Cheshire Name:
Field Type:
Type Name:
Answers Allowed:
Drop Down List:
Lookup File:
Lookup File Name:

SOP1005

TEMP

String

TTSOPText

1

No
No

Number Label
1 [Continuous answer.]

9:51:01 AM Thursday, December 20, 2007

FieldSize:
Min Value:

Max Value:
Mask:

30


Route
SOPRoster - TSOPISHI ( SOP1010 )

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SOP Roster Pop-Up
Item #:

TSOPISHI
Cheshire Name:

Field Type:

Type Name:

Answers Allowed:

Drop Down List:

Lookup File:

Lookup File Name:


TEMP
Enumerated
TTsopishi
1
No
No

Number Label
1 Medicaid

2

3

4

5

6

7

8

9

10

SOP1010

FieldSize:
Min Value:
Max Value:
Mask:

Route

Exit Pop-Up Window.
English text: MEDICAID/MEDICAID MANAGED CARE PLAN
PublicPlan
Exit Pop-Up Window.
English text: OTHER PUBLIC PLAN (OTHER THAN MEDICAID)
PrivatePlan
Exit Pop-Up Window.
English text: PRIVATE HEALTH INSURANCE
NotHIPlanVA
Exit Pop-Up Window.
English text: NOT A HEALTH INSURANCE PLAN (INCLUDING V.A.)
MilitaryPlanNotVA
Exit Pop-Up Window.
English text: MILITARY PLAN (NOT INCLUDING V.A. OR TRICARE)
NotSpsPlan
Exit Pop-Up Window.
English text: NOT SP'S INSURANCE PLAN (PLAN BELONGS TO SOMEONE ELSE)
MHMO
Exit Pop-Up Window.
English text: MEDICARE ADVANTAGE PLAN
DM
Exit Pop-Up Window.
English text: DISCOUNT/SAVINGS MEMBERSHIP
Tricare
Exit Pop-Up Window.
English text: TRICARE
MedicarePartD
Exit Pop-Up Window.
English text: MEDICARE PRESCRIPTION DRUG PLAN

Attribute
Don't know

Route
Exit Pop-Up Window.

9:51:08 AM Thursday, December 20, 2007

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SOP Roster Pop-Up
Refusal
Exit Pop-Up Window.

9:51:08 AM Thursday, December 20, 2007

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File Typeapplication/pdf
File TitlerptMCBSSpecs_RosterMain
AuthorSweeney_l
File Modified2010-03-30
File Created2007-12-20

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