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7bbf486e-20bb-4661-a6b8-817953106101.aspx
  
11.08.08gChemicalPeels11.08.08gSurgery (11)Chemical Peels7bbf486e-20bb-4661-a6b8-8179531061012662Chemical Peels11.08.08
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{"3364": {"Id":3364,"MPAttachmentLetter":"A","Title":"ICD-10 CODES AND NARRATIVES","MPPolicyAttachmentInternalSourceId":5617,"PolicyAttachmentPageName":"b42386b5-d935-4c1e-a24b-2dfec144f1d1"},}
c042c02a-0451-49be-a2c5-a513ea157169.aspx
  
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{"2796": {"Id":2796,"MPAttachmentLetter":"A","Title":"MEDICALLY NECESSARY ICD 10 CODES FOR COBALAMIN (VITAMIN B12) AND/OR FOLIC ACID TESTING (CPT CODES 82607, 82608, 82746, AND 82747)","MPPolicyAttachmentInternalSourceId":4910,"PolicyAttachmentPageName":"3f38e38f-1a5e-4b0a-933d-2b46ca742a4d"},}
52e574a3-d754-4e64-ae47-a5d0662891ef.aspx
  
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f7fbacdf-3a64-436d-99a7-7750aa0ab7d1.aspx
  
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486b7833-e733-47e1-a5a2-1fb22d353084.aspx
  
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3ecc3555-70b4-4662-ae43-bfa5024ef24e.aspx
  
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08.00.94oDenosumab(Prolia®,Xgeva®),Romosozumab-aqqg(Evenity®)08.00.94oPharmacy (08)Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®)0f6392a1-2719-450d-980d-71109cfbbf993185Denosumab (Prolia®, Xgeva®), Romosozumab-aqqg (Evenity®)08.00.94
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00.03.02abDiagnosticRadiologyServicesIncludedinCapitation00.03.02abAdministrative (00)Diagnostic Radiology Services Included in Capitationef37cab5-6501-4d87-acad-5bf9060d23d42960Diagnostic Radiology Services Included in Capitation00.03.02
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{"2913": {"Id":2913,"MPAttachmentLetter":"A","Title":"Procedure Codes for Direct Access OB/GYN","MPPolicyAttachmentInternalSourceId":5193,"PolicyAttachmentPageName":"06aff05f-ffda-49be-930f-087f93089d77"},}
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f8b18be7-798d-4e08-8bad-cf21497a7d5f.aspx
  
08.01.79Dostarlimab-gxly(Jemperli)08.01.79Pharmacy (08)Dostarlimab-gxly (Jemperli)f8b18be7-798d-4e08-8bad-cf21497a7d5f3432Dostarlimab-gxly (Jemperli)08.01.79
e6e62a11-5776-4052-ab2f-c0631761df82.aspx
  
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05.00.21xDurableMedicalEquipment(DME)andConsumableMedicalSupplies05.00.21xDME (05)Durable Medical Equipment (DME) and Consumable Medical Supplies2a6d2214-b38f-490e-9a46-c9e6f6c405343109Durable Medical Equipment (DME) and Consumable Medical Supplies05.00.21
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05.00.48kDurableMedicalEquipment(DME)NotSubjecttoaRentaltoPurchaseMaximum05.00.48kDME (05)Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum7cae1a28-f168-4966-b786-0320a4fa96d42986Durable Medical Equipment (DME) Not Subject to a Rental to Purchase Maximum05.00.48
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