C58, C0283 - Disc MA Payment of Health Insurance Premiums of Inmate of NYS or Local Correctional Facility Read more about C58, C0283 - Disc MA Payment of Health Insurance Premiums of Inmate of NYS or Local Correctional Facility
X52, D0023 - Deny Medicare Buy-In Program QMB Read more about X52, D0023 - Deny Medicare Buy-In Program QMB
V72, U0093 - Intent to Establish Liability Toward Chronic Care Individual No Liability Not Month 1 of Institution Read more about V72, U0093 - Intent to Establish Liability Toward Chronic Care Individual No Liability Not Month 1 of Institution
M30, M0006 - Last Reminder (60 days after initial) to join a plan Read more about M30, M0006 - Last Reminder (60 days after initial) to join a plan
M29, M0005 - First Reminder to Join a Plan Mandatory SSI and non-SSI Read more about M29, M0005 - First Reminder to Join a Plan Mandatory SSI and non-SSI
LDSS 4929 - Upstate Inter-Agency Date of Status (DOS) and Date Entered Country (DEC) Transmittal Form Read more about LDSS 4929 - Upstate Inter-Agency Date of Status (DOS) and Date Entered Country (DEC) Transmittal Form
LDSS 4294 - Explanation of the Effect of Transfer of Asset(s) on Medical Assistance Eligibility (Spanish) Read more about LDSS 4294 - Explanation of the Effect of Transfer of Asset(s) on Medical Assistance Eligibility (Spanish)