CDE Detailed Report
Disease: Sickle Cell Disease
Sub-Domain: Assessments and Examinations
CRF: PhenX Toolkit: Health Insurance Coverage

9 results.
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type Source Form Set Form Field
C59544 Medicare insurance coverage code MedicareInsurCovrgCode Code indicating whether the subject/participant is covered by insurance provided through Medicare Code indicating whether the subject/participant is covered by insurance provided through Medicare Medicare, for people 65 and older, or people with certain disabilities. 1;2;3 Covered;Not Covered;not sure Numeric Values PhenX Protocol: Health Insurance Coverage (#011502) Adult Proposed 1.00 2019-04-11 10:16:19.0 PhenX Toolkit: Health Insurance Coverage Assessments and Examinations Hospital/Care Management

Single Pre-Defined Value Selected

PhenX Core Tier 2 Health Insurance Coverage 1c
C59545 Income disability based government assistance insurance coverage code IncmDsabBsdGovtAsstInsCovCode Code indicating whether the subject/participant is covered by insurance provided through an income or disability based government assistance program such as Medicaid Code indicating whether the subject/participant is covered by insurance provided through an income or disability based government assistance program such as Medicaid Medicaid, Medical Assistance (MA), the Children's Health Insurance Program (CHIP), or any kind of state or government-sponsored assistance. plan based on income or a disability. You may know this type of coverage as [IF THE RESPONDENT IS IN A STATE WITH STATE-SPECIFIC NAMES INSERT PROGRAM NAME]. 1;2;3 Covered;Not Covered;not sure Numeric Values PhenX Protocol: Health Insurance Coverage (#011502) Adult;Pediatric Proposed 1.00 2019-04-11 10:16:19.0 PhenX Toolkit: Health Insurance Coverage Assessments and Examinations Hospital/Care Management

Single Pre-Defined Value Selected

PhenX Core Tier 2 Health Insurance Coverage 1d
C59546 Military insurance coverage code MilitaryInsurCoverageCode Code indicating whether the subject/participant is covered by insurance provided through the military Code indicating whether the subject/participant is covered by insurance provided through the military TRICARE or other military health care, including VA health care. 1;2;3 Covered;Not Covered;not sure Numeric Values PhenX Protocol: Health Insurance Coverage (#011502) Adult;Pediatric Proposed 1.00 2019-04-11 10:16:19.0 PhenX Toolkit: Health Insurance Coverage Assessments and Examinations Hospital/Care Management

Single Pre-Defined Value Selected

PhenX Core Tier 2 Health Insurance Coverage 1e
C59547 Indian Health Service insurance coverage code IHSInsurCoverageCode Code indicating whether the subject/participant is covered by insurance provided through the Indian Health Service (IHS) Code indicating whether the subject/participant is covered by insurance provided through the Indian Health Service (IHS) Indian Health Service. 1;2;3 Covered;Not Covered;not sure Numeric Values PhenX Protocol: Health Insurance Coverage (#011502) Adult;Pediatric Proposed 1.00 2019-04-11 10:16:19.0 PhenX Toolkit: Health Insurance Coverage Assessments and Examinations Hospital/Care Management

Single Pre-Defined Value Selected

PhenX Core Tier 2 Health Insurance Coverage 1f
C59548 Other insurance coverage code OtherInsurCoverageCode Code indicating whether the subject/participant is covered by insurance through a provider not otherwise specified Code indicating whether the subject/participant is covered by insurance through a provider not otherwise specified Any other type of health insurance. coverage or health coverage plan 1;2;3 Covered;Not Covered;not sure Numeric Values PhenX Protocol: Health Insurance Coverage (#011502) Adult;Pediatric Proposed 1.00 2019-04-11 10:16:19.0 PhenX Toolkit: Health Insurance Coverage Assessments and Examinations Hospital/Care Management

Single Pre-Defined Value Selected

PhenX Core Tier 2 Health Insurance Coverage 1g
C59549 Health insurance coverage indicate code HlthInsurCoverageIndCode Code indicating whether the subject/participant is covered by any type of health insurance Code indicating whether the subject/participant is covered by any type of health insurance Does this mean you currently have no health insurance or health coverage plan? In answering this question, please exclude plans that pay for only one type of service (such as, nursing home care, accidents, family planning, or dental care) and plans that only provide extra cash when hospitalized. 1;2 I do NOT have health insurance;I HAVE some kind of health insurance Numeric Values PhenX Protocol: Health Insurance Coverage (#011502) Adult;Pediatric Proposed 1.00 2019-04-11 11:03:21.0 PhenX Toolkit: Health Insurance Coverage Assessments and Examinations Hospital/Care Management

Single Pre-Defined Value Selected

PhenX Core Tier 2 Health Insurance Coverage 2
C59550 Health insurance coverage type HealthInsuranceCoverageTyp Type of health insurance coverage that the subject/participant has Type of health insurance coverage that the subject/participant has What type of health insurance do you have? Alphanumeric PhenX Protocol: Health Insurance Coverage (#011502) Adult;Pediatric Proposed 1.00 2019-04-11 11:07:07.0 PhenX Toolkit: Health Insurance Coverage Assessments and Examinations Hospital/Care Management 100

Free-Form Entry

PhenX Core Tier 2 Health Insurance Coverage 2b
C59542 Employer union provided insurance coverage code EmplUnionProvInsurCovCode Code indicating whether the subject/participant is covered by insurance through a current or former employer or union. Code indicating whether the subject/participant is covered by insurance through a current or former employer or union. Insurance through a current or former employer or union (of yours or another family member's). This would include COBRA coverage. 1;2;3 Covered;Not Covered;not sure Numeric Values PhenX Protocol: Health Insurance Coverage (#011502) Adult;Pediatric Proposed 1.00 2019-04-11 10:16:19.0 PhenX Toolkit: Health Insurance Coverage Assessments and Examinations Hospital/Care Management

Single Pre-Defined Value Selected

PhenX Core Tier 2 Health Insurance Coverage 1a
C59543 Direct purchase insurance coverage code DirectPurchInsurCovrgCode Code indicating whether the subject/participant is covered by insurance purchased directly from an insurance company. Code indicating whether the subject/participant is covered by insurance purchased directly from an insurance company. Insurance purchased directly from an insurance company (by you or another family member). This would include coverage purchased through an exchange or marketplace, such as HealthCare.gov [IF THE RESPONDENT IS IN A STATE WITH STATE-SPECIFIC NAMES, INSERT [or (INSERT PROGRAM NAME)]]. 1;2;3 Covered;Not Covered;not sure Numeric Values PhenX Protocol: Health Insurance Coverage (#011502) Adult;Pediatric Proposed 1.00 2019-04-11 10:16:19.0 PhenX Toolkit: Health Insurance Coverage Assessments and Examinations Hospital/Care Management

Single Pre-Defined Value Selected

PhenX Core Tier 2 Health Insurance Coverage 1b
9 results.
CSV