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MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL W3 Disabled widower (2nd claimant) W4 Disabled widow (3rd claimant) W5 Disabled widower (3rd claimant) W6 Disabled surviving divorced wife (1st claimant) W7 Disabled surviving divorced wife (2nd claimant) W8 Disabled surviving divorced wife (3rd claimant) W9 Disabled widow (4th claimant) WB Disabled widower (4th claimant) WC Disabled surviving divorced wife (4th claimant) WF Disabled widow (5th claimant) WG Disabled widower (5th claimant) WJ Disabled surviving divorced wife (5th claimant) WR Disabled surviving divorced husband (1st claimant) WT Disabled surviving divorced husband (2nd claimant)

NOTE: Some BICs may be displayed as a three-position code (e.g., B01, C03, etc.). The “0” is a filler and should not be entered on the NOMADS screen.

Division of Welfare and Supportive Services APPENDIX E Medical Assistance Manual MEDICAL ASSISTANCE PROGRAM MANUAL MTL 02/13 01 Nov 13 BIC CODE VALUES