Commercial
Type
  
Name
  
MPDispTitle
  
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392d49d2-7243-434c-ad16-76d28c0d78f6.aspx
  
Saturation Needle Biopsy of the Prostate11.11.06hSurgery (11)Saturation Needle Biopsy of the Prostate392d49d2-7243-434c-ad16-76d28c0d78f63519Saturation Needle Biopsy of the Prostate11.11.069/10/2021 11:00 AM
aa4b200c-018c-49df-9b29-125338ccc489.aspx
  
RadiationTherapyServices(Independence)09.00.56m09.00.56mRadiology (09)Radiation Therapy Services (Independence)aa4b200c-018c-49df-9b29-125338ccc4893512Radiation Therapy Services (Independence)09.00.568/31/2021 10:00 AM
{"3513": {"Id":3513,"MPAttachmentLetter":"A","Title":"CPT, HCPCS and Revenue Codes","MPPolicyAttachmentInternalSourceId":5685,"PolicyAttachmentPageName":"81b05239-c40f-417f-b070-a3ee96e0fc89"},}
10/1/2021
05ef3be0-6a22-4ef4-bbd0-11dd4684a353.aspx
  
Interleukin-5(IL-5)Antagonist(e.g.,Cinqair®)08.01.23i08.01.23iPharmacy (08)Interleukin-5 (IL-5) Antagonist (e.g., Cinqair®)05ef3be0-6a22-4ef4-bbd0-11dd4684a3533421Interleukin-5 (IL-5) Antagonist (e.g., Cinqair®)08.01.237/6/2021 1:00 PM
10/4/2021
6a72d9f5-3dda-4abe-a81e-70d78612bc38.aspx
  
Omalizumab(Xolair®)08.00.55i08.00.55iPharmacy (08)Omalizumab (Xolair®)6a72d9f5-3dda-4abe-a81e-70d78612bc383468Omalizumab (Xolair®)08.00.557/6/2021 1:00 PM
{"3469": {"Id":3469,"MPAttachmentLetter":"A","Title":"Dosing and Frequency Requirements for Omalizumab (Xolair®)","MPPolicyAttachmentInternalSourceId":5480,"PolicyAttachmentPageName":"f10dd46e-8c92-48e6-be08-f43ac674c022"},}
10/4/2021
3367b1e8-fbb9-4d6d-9821-2ae901947fa7.aspx
  
UltravioletLightTherapyfortheTreatmentofDermatologicalConditions07.07.02l07.07.02lMedicine (07)Ultraviolet Light Therapy for the Treatment of Dermatological Conditions3367b1e8-fbb9-4d6d-9821-2ae901947fa73532Ultraviolet Light Therapy for the Treatment of Dermatological Conditions07.07.028/13/2021 2:00 PM
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11/15/2021
9821f9b8-ea7b-41f4-a535-2abf4ead83a1.aspx
  
TreatmentofPulmonaryArteryHypertensionwithIntravenous,Subcutaneous,andInhaledPharmacologicAgents08.00.25m08.00.25mPharmacy (08)Treatment of Pulmonary Artery Hypertension with Intravenous, Subcutaneous, and Inhaled Pharmacologic Agents9821f9b8-ea7b-41f4-a535-2abf4ead83a13489Treatment of Pulmonary Artery Hypertension with Intravenous, Subcutaneous, and Inhaled Pharmacologic Agents08.00.258/18/2021 1:00 PM
{"3490": {"Id":3490,"MPAttachmentLetter":"A","Title":"Dosing and Frequency Requirements","MPPolicyAttachmentInternalSourceId":5447,"PolicyAttachmentPageName":"ee10ef07-f8a8-4d5d-b2f5-c9285551afe1"},}
11/22/2021
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