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Prior Authorization / Residential Substance Use Disorder Treatment Attachment (PA/RSUD)

Assigned Number Title Release Date File Type Language Available to Order
F-02567 Prior Authorization / Residential Substance Use Disorder Treatment Attachment (PA/RSUD) 02/13/2023 PDF English No
F-02567 Prior Authorization / Residential Substance Use Disorder Treatment Attachment (PA/RSUD) 02/13/2023 Word English No
F-02567A Prior Authorization / Residential Substance Use Disorder Treatment Attachment (PA/RSUD), Instructions 02/13/2023 PDF English No
Last revised May 10, 2024