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APPENDIX B Ohio Department of Medicaid JFK 07216 B (Rev. 11/2013) American Indian or Alaska Native Family Member (AI/AN) Complete this appendix if you or a family member are American Indian or Alaska

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What is appendix b - form?

Appendix B - Form is a document used to report certain information to the relevant regulatory authorities.

Who is required to file appendix b - form?

Entities or individuals who meet the criteria set by the regulatory authorities are required to file Appendix B - Form.

How to fill out appendix b - form?

Appendix B - Form can be filled out by providing all the required information accurately and following the instructions provided by the regulatory authorities.

What is the purpose of appendix b - form?

The purpose of Appendix B - Form is to ensure transparency and compliance with regulations by reporting necessary information to the relevant authorities.

What information must be reported on appendix b - form?

Appendix B - Form requires the reporting of specific details such as financial information, transactions, and other relevant data as per the regulations.