Prior Authorization / Child / Adolescent Day Treatment Attachment (PA/CADTA)

Assigned Number Title Release Date File Type Language Available to Order
F-11040 Prior Authorization / Child / Adolescent Day Treatment Attachment (PA/CADTA) 12/16/2019 PDF English
F-11040A Prior Authorization / Child / Adolescent Day Treatment Attachment (PA/CADTA) Instructions 12/16/2019 PDF English
F-11040 Prior Authorization / Child / Adolescent Day Treatment Attachment (PA/CADTA) 12/16/2019 Word English

Glossary

 
Last revised September 19, 2024