XEROX 99D-Appendix1
This table contains information that is common to the Prior Authorization requests. ... 5 Outpat Rev Outpatient Revenue Code A-SVC-OUTPA-REV-CD ... 042 Qual Ind qualifying individuals QUAL-IND. 044 QMB Und 65 QMB - Under 65 QMB-UNDER-65 ... ................
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