dma-2056 Purchased Medical Transportation Costs
| Medicaid Form Number | dma-2056 |
| Agency/Division | Health Benefits/NC Medicaid (DHB) |
| Form Effective Date | 2018-12-19T15:20:00-04:00 |
| Form File | dma-2056.xls |
| Medicaid Form Number | dma-2056 |
| Agency/Division | Health Benefits/NC Medicaid (DHB) |
| Form Effective Date | 2018-12-19T15:20:00-04:00 |
| Form File | dma-2056.xls |