DHS Search Results
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Medicaid Disability Redetermination Report
… Facility Where Test Was Done Electrocardiogram (EKG) Chest X-Ray Other X-Ray (Describe below.) Breathing test Blood test (Describe below.) Other Test (Describe below.) Describe the types of … Where Test Was Done 1 10114: Chest X-Ray 10114: Off Other X-Ray (Describe below: ) 10114: Off Breathing test 10114: Off Blood test (Describe below: ) 10114: Off Other Test (Describe below: ) … -
New Enrollee Health Needs Assessment (NEHNA) Survey - Enrollee Version
… medicine for any of the following medical conditions? Asthma (“attacks” of difficult breathing) If yes: Who? Diabetes (high or low blood sugar) Who? High blood pressure Who? Heart … -
Medicaid Disability Application
… No Echocardiogram or Cardiac Catheterization Yes No MRI/ X-ray/CT Scan Which body part: Yes No Breathing Tests Yes No Blood Tests Yes No Other Tests Specify Yes No MADA MEDICAID DISABILITY …