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[DOC File]Aid Codes Master Chart (aid codes) -cal.ca.gov
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This code is not valid for an infant using the mother’s ID. 0G Full No MCAP (Title XXI). Provides full-scope, no SOC health care services (medical, dental, and vision), through fee-for-service Medi-Cal, to pregnant women who are California residents with a MAGI above 213 percent and up to and including 322 percent of the FPL.
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[DOC File]SAMPLE GOALS AND OBJECTIVES - DecisionHealth
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SAMPLE GOALS AND OBJECTIVES. SMART TREATMENT PLANNING. Diagnosis: Depressive Disorder (and Bipolar depressed) Goal: Resolution of depressive symptoms. Objectives: Patient will contract for safety with staff at least once per shift. Patient …
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[PDF File]SECONDARY AUTHORIZATION REQUEST (SAR) FORM Fax to 1 …
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Date of Service and/or Anticipated Length of Care: CPT/HCPCS Code and/or Description of Requested Service (include units/visits, add second list pageif needed):, How many visits have occurredso far? (If known ) Is this a referral to another specialty? Yes No If yes, please fill out the Servicing Provider/Specialty information below.
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[DOC File]Sample Schedule A Letter - Veterans Benefits Administration
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Sample Schedule A Letter from the Department of Labor’s Office of Disability and Employment Policy: Date . To Whom It May Concern: This letter serves as certification that (Veteran’s name) is a person with a severe disability that qualifies him/her for consideration under the Schedule A hiring authority.
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