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APPENDIX B CROSSWALK OF PROGRAMS TO EB01 EB03 EB04 AND EB05 The following tables identify the applicable EB01 EB03 and EB04 codes. October 1 2003 revisions to the Companion Guide for the 270/271 Health Care Eligibility Inquiry and Response Version 4010A1 dated July 17 2003 include Loop 2100D REF02 Reference Identification HIPAA IG p. 275 Loop 2100C DTP03 Date/Time Period HIPAA IG p. 88 this document p. 1. November 7 2003 revisions to the Companion Guide for the 270/271 Health Care...
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Individuals applying for specific programs or services provided by the Michigan Department of Community, such as childcare assistance, food assistance, or medical assistance.
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The Michigan Department of Community is a government agency in the state of Michigan that focuses on community development and services.
Various organizations and entities in Michigan may be required to file with the Department of Community, depending on the specific requirements and regulations.
To fill out the Michigan Department of Community form, you will need to provide information about your organization, community development projects, and services provided.
The purpose of the Michigan Department of Community is to promote community development and provide services to the residents of Michigan.
Information such as details of community projects, services offered, funding sources, and impact on the community may need to be reported on the Michigan Department of Community form.
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