| Assigned Number |
Title |
Version Date | Publication Type | Other Location | Language |
|---|---|---|---|---|---|
| F-00212 | Completion Instructions | December 16, 2019 |
PDF
|
None | English |
| F-00212 | Prior Authorization/Intensive In-Home Mental Health and Substance Abuse Services Assessment and Recovery/Treatment Plan Attachment | February 1, 2010 |
Word
|
None | English |
| F-00212 | Prior Authorization/Intensive In-Home Mental Health and Substance Abuse Services Assessment and Recovery/Treatment Plan Attachment | February 1, 2010 |
PDF
|
None | English |
Last Revised: December 16, 2019
