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APPENDIX B CHECKLIST OF BENEFITS Names of the individual: Date of birth: Social Security No. Is the individual receiving or expected to receive any of the following means tested public benefits? Medicaid
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It is a checklist of items that need to be completed or verified.
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The appendix b- checklist of can typically be filled out by providing the required information or checking off the necessary items.
The purpose of the appendix b- checklist of is to ensure compliance with specific requirements or regulations.
The specific information that must be reported on the appendix b- checklist of will depend on the individual requirements.
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