New Jersey. Department of Human Services. Division of Medical Assistance and Health Services2021-06-212021-06-211987-11-09974.905 M484https://hdl.handle.net/10929/71443Downloaded from: state.nj.us/humanservices/dmahs/info/resources/medicaid/#17en-USNew JerseyMedicaidMedicaid CommunicationRetroactive Eligibility: Revisions to the Application for Payment of Unpaid Medical Bills (FD-74 Form)