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us-mt/manual/dphhs/medicaid/aca004/page-2 — Page 2 · Axiom

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Axiom
Montana
Manual
Dphhs
Medicaid
Aca004
Page 2

Page 2

Official source

13 $11,006 14 $11,749 15 $12,492 16 $13,235

Effective Date: 04/01/2026

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