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BEM 101 11 of 15 MA DESK AIDS BPB 2017-008 4-1-2017

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

Laboratory Only Plans Code Code Description 85 Laboratory Only Plans Code

Vision Only Plans Code Description 86 Vision Only Plans Pharmacy Only Plans Code Description 87 Pharmacy Only Plans Dental Only Plans

Code Description 88 Dental Only Plans Code (includes Delta Dental Plan of Michigan)

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