by skozmic | Mar 24, 2025 | Archived
Archive Date: 03/23/2025; Archived for Premera: 04/20/2025; Archived for Regence: 05/18/2025; Archived for Simply Healthcare Florida Medicaid: 04/04/2026 This document has been archived because it has outdated information. It is for historical information only and...
by skozmic | Mar 24, 2025 | Archived
Archive Date: 03/23/2025; Archived for Premera: 04/20/2025; Archived for Regence: 05/18/2025; Archived for Simply Healthcare Florida Medicaid: 04/04/2026 This document has been archived because it has outdated information. It is for historical information only and...
by skozmic | Nov 19, 2024 | Archived
Archive Date: 04/04/2026 This document has been archived because it has outdated information. It is for historical information only and should not be consulted for clinical use. Current versions of guidelines are available on the Carelon Medical Benefits Management...
by skozmic | Nov 19, 2024 | Current
Link to PDF Status: Reaffirmed Effective Date:03/23/2025 Doc ID: RAD01-0325.1-R0725 Last Review Date: 07/17/2025 Approval and implementation dates for specific health plans may vary. Please consult the applicable health plan for more details. Clinical Appropriateness...
by skozmic | Nov 19, 2024 | Archived
Archive Date: 04/04/2026 This document has been archived because it has outdated information. It is for historical information only and should not be consulted for clinical use. Current versions of guidelines are available on the Carelon Medical Benefits Management...
