Additional Forms
- DHEC Family Planning Application
- DHEC Family Planning Application - Spanish
- 3400-Appendix B, American Indian or Alaska Native Family Member
- Form 227
- Presumptive Eligibility Application
- FM 905
- FM 943
- Form 3400-B
- Form 3400 DHEC
- Request for Medicaid ID Number – Infant
- Annual Review Form
- Form 1282-Authorization for Release of Information and Appointment of Authorized Representative
- Voter Registration Packet
- Civil Rights Discrimination Complaint Form
- Health Information Privacy Complaint
Provider Documents
Carrier Codes
- Megallan Carrier Code List Alpha
6/30/2017 (MS Excel Spread sheet) - Megallan Carrier Code List Numeric
6/30/2017 (MS Excel Spread sheet) - Carrier Code List Alpha
6/30/2017 (MS Excel Spread sheet) - Carrier Code List Numeric
6/30/2017 (MS Excel Spread sheet) - Medicare Advantage Plan Carriers
6/30/2017 (MS Excel Spread sheet)