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Who is this coverage for?
Beneficiary?
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Used Tobacco past 2 years?
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Cancer Ever?
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COPD Ever?
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Heart Attack / Stroke Ever?
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Insulin for Diabetes Ever?
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HIV / AIDS Ever?
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COVID -19 Ever?
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Kidney or Liver Disease Ever?
Prescription Medications:
High Blood Pressure?
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Diabetes (Metformin) - Pills Only?
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Anxiety or Depression?
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