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Florida Medicaid
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Florida Medicaid
Coordination of benefits
Florida Medicaid coordination of benefits
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Florida Medicaid member first name
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Florida Medicaid member last name
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Florida Medicaid ID number
Name of other insurance company
Other insurance address/phone
Name of family member insured through them
Relationship of family member to Florida Medicaid member
Effective date of other coverage
Group, policy, and member numbers of other coverage
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Last Updated: 12/21/2021
