Chest CTA and CT for Pulmonary Emboli Criteria Iowa Medicaid Program: - PDF Document
Chest CTA and CT for Pulmonary Emboli Criteria. Iowa Medicaid Program: Prior Authorization Revision Number:. 10/19/2012 1/15/2016. Effective Date: Last Review Date: Next Review Date: Approved Date:. 4. Medicaid Clinical Advisory Committee Medical Director. 1/2017.
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