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Get and Sign DHS Form 1144E Department of Human Services Med Quest Med Quest 2003-2022
Physician To be completed by Case Management Supplier Code T1016-22 T1016-EP T1016 Item Qty. T1030 T1021 Medicaid Only A Approved P Pended D Denied R Revoked Period Approved Comments Qty. /Mo. Auth. Skilled Nursing services in the home by hourly basis. Personal Care Services in the home When submitting a claim indicate the service hours provided by the RN with the code T1030 indicate the service hours provided by the LPN with the code T1030-52. STATE OF HAWAII Department of Human Services...
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