Appendix 01 (A01 to A62) | Appendix 02 (B01 to B35) | Appendix 03 (C001 to C032) Appendix 04 (D01 to D44) | Appendix 05 (E01 to E34) | Appendix 06 (F001 to F101) Appendix 01 (A01 to A62) A01 to A10 Assistance Directory A11 Medical Assistance Coupons A12 to A19 Policy Manual Definitions 2 A20 Provider Correspondence Form 239 A21 Form 239 Instructions A22 to A48 Sample Remittance Advice A49 Sample Medicaid ID Card A50 to A54 Services & Items Not Covered A55 to A62 Services & Items Require Auth.
Appendix 01 (A01 to A62) | Appendix 02 (B01 to B35) | Appendix 03 (C001 to C032) Appendix 04 (D01 to D44) | Appendix 05 (E01 to E34) | Appendix 06 (F001 to F101)
Appendix 01 (A01 to A62)
© Hawaii State Med-QUEST Division, 2003
