Prior authorization codes
Humana Inc.
Active CPT codes that appear on the extracted prior authorization list for this health plan.
| Code | Procedure / Service | Effective | Revised | Confidence | Source |
|---|---|---|---|---|---|
| 0005U | 0029U, 0037U, 0045U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0020M | 0029U, 0037U, 0045U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0026U | 0029U, 0037U, 0045U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0029U | 0620U, 0630U, 0087U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0037U | 0620U, 0630U, 0087U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0045U | 0620U, 0630U, 0087U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0087U | 0088U, 0089U, 0090U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0088U | 0118U, 0172U, 0211U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0089U | 0118U, 0172U, 0211U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0090U | 0118U, 0172U, 0211U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0095T | 0165T, 0202T, 0219T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0098T | 0165T, 0202T, 0219T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0118U | 0212U, 0213U, 0214U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0164T | 0165T, 0202T, 0219T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0165T | 0220T, 0221T, 0222T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0172U | 0212U, 0213U, 0214U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0202T | 0220T, 0221T, 0222T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0211U | 0212U, 0213U, 0214U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0212U | 0216U, 0217U, 0239U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0213T | 0214T, 0215T, 0216T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0213U | 0216U, 0217U, 0239U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0214T | 0217T, 0218T | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0214U | 0216U, 0217U, 0239U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0215T | 0217T, 0218T | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0216T | 0217T, 0218T | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0216U | 0242U, 0245U, 0250U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0217T | Facility-based sleep studies 95807, 95808, 95810, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0217U | 0242U, 0245U, 0250U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0218T | Facility-based sleep studies 95807, 95808, 95810, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0219T | 0220T, 0221T, 0222T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0220T | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0221T | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0222T | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0234T | Peripheral revascularization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0235T | Peripheral revascularization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0236T | Peripheral revascularization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0237T | (atherectomy, angioplasty) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0238T | (atherectomy, angioplasty) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0239U | 0242U, 0245U, 0250U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0242U | 0299U, 0313U, 0315U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0245U | 0299U, 0313U, 0315U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0250U | 0299U, 0313U, 0315U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0253T | Micro-Invasive Glaucoma Surgery | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0274T | 0719T, 0790T, C1821, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0299U | 0326U, 0329U, 0333U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0313U | 0326U, 0329U, 0333U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0315U | 0326U, 0329U, 0333U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0326U | 0334U, 0340U, 0345U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0329U | 0334U, 0340U, 0345U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0333U | 0334U, 0340U, 0345U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0334U | 0347U, 0349U, 0355U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0338T | technology | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0339T | technology | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0340U | 0347U, 0349U, 0355U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0345T | information MitraClip) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0345U | 0347U, 0349U, 0355U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0347U | 0356U, 0358U, 0359U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0349U | 0356U, 0358U, 0359U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0355U | 0356U, 0358U, 0359U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0356U | 0378U, 0379U, 0388U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0358U | 0378U, 0379U, 0388U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0359U | 0378U, 0379U, 0388U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0362T | (ABA) /adaptive behavior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0373T | (ABA) /adaptive behavior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0378U | 0411U, 0419U, 0422U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0379U | 0411U, 0419U, 0422U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0388U | 0411U, 0419U, 0422U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0408T | • Additional provider | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0409T | • Additional provider | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0410T | • Additional provider | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0411T | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0411U | 0433U, 0434U, 0437U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0412T | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0413T | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0414T | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0415T | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0416T | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0417T | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0418T | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0419U | 0433U, 0434U, 0437U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0422U | 0433U, 0434U, 0437U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0433U | 0449U, 0473U, 0475U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0434U | 0449U, 0473U, 0475U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0437U | 0449U, 0473U, 0475U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0446T | 0716T (managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0447T | 0716T (managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0448T | 0716T (managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0449T | (MIGs) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0449U | 0485U, 0486U, 0487U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0450T | (MIGs) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0473U | 0485U, 0486U, 0487U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0475U | 0485U, 0486U, 0487U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0485U | 0489U, 0493U, 0510U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0486U | 0489U, 0493U, 0510U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0487U | 0489U, 0493U, 0510U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0489U | 0532U, 0533U, 0534U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0493U | 0532U, 0533U, 0534U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0505T | (atherectomy, angioplasty) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0510U | 0532U, 0533U, 0534U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0524T | Ventricular assist devices Percutaneous ventricular 33990, 33991, 33995 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0532U | 0537U, 0538U, 0539U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0533U | 0537U, 0538U, 0539U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0534U | 0537U, 0538U, 0539U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0537U | 0540U, 0543U, 0549U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0538U | 0540U, 0543U, 0549U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0539U | 0540U, 0543U, 0549U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0540U | 0552U, 0553U, 0554U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0543U | 0552U, 0553U, 0554U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0549U | 0552U, 0553U, 0554U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0552U | 0555U, 0560U, 0561U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0553U | 0555U, 0560U, 0561U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0554U | 0555U, 0560U, 0561U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0555U | 0562U, 0565U, 0566U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0560U | 0562U, 0565U, 0566U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0561U | 0562U, 0565U, 0566U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0562U | 0567U, 0569U, 0571U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0565U | 0567U, 0569U, 0571U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0566U | 0567U, 0569U, 0571U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0567U | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0569U | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0571T | authorization request) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0571U | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0572T | authorization request) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0572U | 0578U, 0585U, 0602U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0573T | authorization request) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0574T | authorization request) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0575U | 0578U, 0585U, 0602U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0576U | 0578U, 0585U, 0602U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0577T | authorization request) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0578U | 0605U, 0611U, 0612U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0580T | • Phone: 833-283-0033 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0582T | Requests can be submitted | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0584T | 0586T, G0341, G0342, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0585T | 0586T, G0341, G0342, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0585U | 0605U, 0611U, 0612U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0586T | G0343, L8698, 02WA3QZ, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0587T | 0588T, 0783T, 0786T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0588T | 0787T, 0816T, 0817T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0600T | on Evolent's website, or you | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0601T | on Evolent's website, or you | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0602U | 0605U, 0611U, 0612U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0605U | 0613U, 0616U, 0618U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0611U | 0613U, 0616U, 0618U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0612U | 0613U, 0616U, 0618U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0613U | 0619U, 0620U, 0622U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0614T | • Phone: 833-283-0033 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0616U | 0619U, 0620U, 0622U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0618U | 0619U, 0620U, 0622U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0619U | 0623U, 0624U, 0625U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0620U | 0088U, 0089U, 0090U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0622U | 0623U, 0624U, 0625U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0623U | 0626U, 0627U, 0628U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0624U | 0626U, 0627U, 0628U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0625U | 0626U, 0627U, 0628U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0626U | 0630U | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0627T | Percutaneous lumbar | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0627U | 0630U | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0628T | Percutaneous lumbar | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0628U | 0630U | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0629T | Percutaneous lumbar | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0630T | intravertebral disc injection | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0630U | 0088U, 0089U, 0090U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0651T | Cardiac devices Aortic repair 33875, 33877, 33880, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0656T | 0719T, 0790T, C1821, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0657T | 0719T, 0790T, C1821, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0660T | (MIGs) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0661T | (MIGs) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0671T | Molecular diagnostic and 81105, 81112, 81120, 81121, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0716T | (managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0719T | C2614, C9757 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0745T | Health) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0746T | Health) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0747T | C1735, C1736, E0738, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0783T | 0787T, 0816T, 0817T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0784T | Spinal cord stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0785T | Spinal cord stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0786T | 0787T, 0816T, 0817T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0787T | 0818T, 0819T, 0908T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0790T | C2614, C9757 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0795T | • Phone: 833-283-0033 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0796T | • Phone: 833-283-0033 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0797T | 8 a.m. – 8 p.m., Eastern | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0798T | 8 a.m. – 8 p.m., Eastern | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0799T | 8 a.m. – 8 p.m., Eastern | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0800T | 8 a.m. – 8 p.m., Eastern | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0801T | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0802T | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0803T | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0805T | information MitraClip) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0806T | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0813T | Obesity surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0816T | 0818T, 0819T, 0908T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0817T | 0818T, 0819T, 0908T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0818T | 0909T, 0910T, 0911T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0819T | 0909T, 0910T, 0911T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0823T | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0824T | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0825T | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0826T | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0908T | 0909T, 0910T, 0911T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0909T | 0912T, 0956T, 0957T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0910T | 0912T, 0956T, 0957T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0911T | 0912T, 0956T, 0957T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0912T | 0958T, 0959T, 0960T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0913T | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0914T | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0915T | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0916T | Expedited/urgent cases can be 0920T, 0921T, 0922T, 0923T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0917T | Expedited/urgent cases can be 0920T, 0921T, 0922T, 0923T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0918T | Expedited/urgent cases can be 0920T, 0921T, 0922T, 0923T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0919T | Expedited/urgent cases can be 0920T, 0921T, 0922T, 0923T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0920T | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0921T | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0922T | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0923T | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0924T | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0925T | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0926T | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0927T | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0933T | Cohere Health portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0934T | Cohere Health portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0935T | C1735, C1736, E0738, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0947T | C1735, C1736, E0738, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0950T | on Evolent's website, or you | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0956T | 0958T, 0959T, 0960T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0957T | 0958T, 0959T, 0960T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0958T | 0968T, 0969T, 0988T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0959T | 0968T, 0969T, 0988T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0960T | 0968T, 0969T, 0988T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0968T | 0989T, 1013T, 1014T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0969T | 0989T, 1013T, 1014T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0970T | mastectomies for breast | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0971T | mastectomies for breast | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0977T | Cardiac devices Aortic repair 33875, 33877, 33880, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0981T | Cohere Health portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0982T | Cohere Health portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0983T | C1722, C1777, C1779, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0988T | 0989T, 1013T, 1014T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0989T | 1015T, C1607, C1767, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0994T | Prior authorization requests for 0995T | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 0995T | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 1013T | 1015T, C1607, C1767, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 1014T | 1015T, C1607, C1767, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 1015T | C1787, C1826, C1827, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 11971 | Other breast procedures | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 14601 | P.O. Box | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 15820 | Blepharoplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 15821 | Blepharoplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 15822 | Blepharoplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 15823 | 67904, 67908, 67909, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 15830 | Abdominoplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 15847 | Abdominoplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 17106 | Cutaneous vascular lesion | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 17107 | Cutaneous vascular lesion | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 17108 | Cutaneous vascular lesion | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19120 | Breast procedures Breast cancer biopsy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19125 | Breast procedures Breast cancer biopsy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19300 | Simple mastectomy and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19301 | Breast lumpectomy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19302 | Breast lumpectomy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19303 | Simple mastectomy and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19316 | Other breast procedures | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19318 | Other breast procedures | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19325 | (excludes breast | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19328 | (excludes breast | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19330 | (excludes breast | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19340 | reconstruction following | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19342 | reconstruction following | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19350 | reconstruction following | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19357 | medically necessary | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19370 | medically necessary | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19371 | medically necessary | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 19380 | mastectomies for breast | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 20910 | Oral, orthognathic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 20982 | Ablation Bone, liver, kidney prostate | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 20983 | Ablation Bone, liver, kidney prostate | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 20999 | Spinal fusion, decompression | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21010 | Oral, orthognathic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21050 | Oral, orthognathic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21070 | temporomandibular joint (TMJ) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21081 | Prosthetics | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21082 | Prosthetics | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21084 | Prosthetics | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21085 | temporomandibular joint (TMJ) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21100 | surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21110 | surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21125 | 21142, 21143, 21145, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21127 | 21142, 21143, 21145, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21141 | 21142, 21143, 21145, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21142 | 21146, 21147, 21150, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21143 | 21146, 21147, 21150, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21145 | 21146, 21147, 21150, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21146 | 21151, 21154, 21155, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21147 | 21151, 21154, 21155, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21150 | 21151, 21154, 21155, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21151 | 21159, 21160, 21188, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21154 | 21159, 21160, 21188, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21155 | 21159, 21160, 21188, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21159 | 21193, 21194, 21195, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21160 | 21193, 21194, 21195, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21188 | 21193, 21194, 21195, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21193 | 21196, 21198, 21199, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21194 | 21196, 21198, 21199, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21195 | 21196, 21198, 21199, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21196 | 21206, 21208, 21210, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21198 | 21206, 21208, 21210, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21199 | 21206, 21208, 21210, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21206 | 21215, 21240, 21242, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21208 | 21215, 21240, 21242, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21210 | 21215, 21240, 21242, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21215 | 21243, 21244, 21247, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21240 | 21243, 21244, 21247, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21242 | 21243, 21244, 21247, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21243 | 29800, 29804 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21244 | 29800, 29804 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21247 | 29800, 29804 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 21685 | Surgery for obstructive sleep | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22100 | Spinal fusion, decompression | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22101 | Spinal fusion, decompression | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22102 | kyphoplasty and vertebroplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22103 | kyphoplasty and vertebroplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22510 | The following services will now be 22513, 22514, 22515, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22511 | The following services will now be 22513, 22514, 22515, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22512 | The following services will now be 22513, 22514, 22515, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22513 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22514 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22515 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22526 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22527 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22532 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22533 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22534 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22548 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22551 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22552 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22554 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22556 | 22586, 22590, 22595, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22558 | 22586, 22590, 22595, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22585 | 22586, 22590, 22595, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22586 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22590 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22595 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22600 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22610 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22612 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22614 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22630 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22632 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22633 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22634 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22800 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22802 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22804 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22808 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22810 | • Cohere Health’s portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22812 | • Cohere Health’s portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22818 | • Cohere Health’s portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22819 | (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22830 | (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22836 | (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22837 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22838 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22840 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22841 | • Information and to | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22842 | • Information and to | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22843 | • Information and to | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22844 | request a new account | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22845 | request a new account | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22846 | request a new account | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22847 | • Additional provider | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22848 | • Additional provider | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22849 | • Additional provider | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22853 | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22854 | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22856 | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22857 | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22858 | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22859 | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22860 | authorization request) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22861 | authorization request) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22862 | authorization request) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22867 | • Phone: 833-283-0033 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22868 | • Phone: 833-283-0033 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22869 | • Phone: 833-283-0033 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22870 | Monday – Friday | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 22899 | Monday – Friday | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 23472 | Orthopedic surgeries: hip, knee | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 23473 | Orthopedic surgeries: hip, knee | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 23474 | Orthopedic surgeries: hip, knee | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 23929 | Orthopedic surgeries: hip, knee | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 26535 | Foot surgeries, bunionectomy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 26536 | Foot surgeries, bunionectomy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27096 | Sacroiliac joint injections | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27125 | and shoulder arthroplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27130 | and shoulder arthroplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27132 | and shoulder arthroplasty | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27134 | The following services will now be 27437, 27438, 27440, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27137 | The following services will now be 27437, 27438, 27440, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27138 | The following services will now be 27437, 27438, 27440, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27278 | Monday – Friday | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27279 | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27280 | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27299 | Orthopedic surgeries: hip, knee | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27412 | Orthopedic surgeries: hip, knee | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27437 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27438 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27440 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27441 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27442 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27443 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27446 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27447 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27486 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27487 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 27599 | and shoulder arthroscopy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28110 | Foot surgeries, bunionectomy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28240 | and hammertoe | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28285 | and hammertoe | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28289 | and hammertoe | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28291 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28292 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28295 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28296 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28297 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28298 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28299 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28306 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28308 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28310 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28740 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 28750 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29800 | Orthopedic surgeries: hip, knee 23472, 23473, 23474, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29804 | Orthopedic surgeries: hip, knee 23472, 23473, 23474, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29805 | and shoulder arthroscopy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29806 | and shoulder arthroscopy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29807 | The following services will now be 29821, 29822, 29823, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29819 | The following services will now be 29821, 29822, 29823, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29820 | The following services will now be 29821, 29822, 29823, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29821 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29822 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29823 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29824 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29825 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29826 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29827 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29828 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29848 | Decompression of peripheral | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29850 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29851 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29860 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29861 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29862 | 29867, 29868, 29870, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29863 | 29867, 29868, 29870, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29866 | 29867, 29868, 29870, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29867 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29868 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29870 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29871 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29873 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29874 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29875 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29876 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29877 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29879 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29880 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29881 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29882 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29883 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29884 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29885 | • Cohere Health’s portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29886 | • Cohere Health’s portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29887 | • Cohere Health’s portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29888 | (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29889 | (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29914 | (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29915 | • Information and to | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29916 | • Information and to | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 29999 | • Information and to | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30400 | Rhinoplasty and other nasal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30410 | Rhinoplasty and other nasal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30420 | Rhinoplasty and other nasal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30430 | procedures | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30435 | procedures | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30450 | procedures | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30460 | 30469 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30462 | 30469 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30468 | 30469 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 30469 | Sacroiliac joint injections 27096 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31237 | Surgical nasal/sinus Excludes diagnostic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31240 | Surgical nasal/sinus Excludes diagnostic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31242 | Surgical nasal/sinus Excludes diagnostic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31243 | endoscopic procedures and nasal/sinus endoscopies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31253 | endoscopic procedures and nasal/sinus endoscopies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31254 | endoscopic procedures and nasal/sinus endoscopies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31255 | balloon sinus ostial dilation | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31256 | balloon sinus ostial dilation | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31257 | balloon sinus ostial dilation | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31259 | 31287, 31288, 31295, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31267 | 31287, 31288, 31295, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31276 | 31287, 31288, 31295, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31287 | 31296, 31297, 31298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31288 | 31296, 31297, 31298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31295 | 31296, 31297, 31298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31296 | 69705, 69706 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31297 | 69705, 69706 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31298 | 69705, 69706 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31647 | Emerging technology/new | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31648 | Emerging technology/new | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31649 | Emerging technology/new | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 31651 | indications for existing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32096 | Lung biopsy and resection Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32097 | Lung biopsy and resection Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32505 | Lung biopsy and resection Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32607 | Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32608 | Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32666 | Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32701 | Radiation therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32850 | Transplant surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32851 | Transplant surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32852 | Transplant surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32853 | 33928, 33929, 33935, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 32854 | 33928, 33929, 33935, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33206 | services managed by Cohere Cardiac implantable devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33207 | services managed by Cohere Cardiac implantable devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33208 | services managed by Cohere Cardiac implantable devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33212 | services managed by Cohere Cardiac implantable devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33213 | Health. Requests can be (e.g., CardioMEMS | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33214 | Health. Requests can be (e.g., CardioMEMS | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33216 | Health. Requests can be (e.g., CardioMEMS | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33217 | pacemakers, leadless | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33221 | pacemakers, leadless | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33224 | pacemakers, leadless | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33225 | submitted using the options pacemakers, left atrial | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33227 | submitted using the options pacemakers, left atrial | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33228 | submitted using the options pacemakers, left atrial | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33229 | submitted using the options pacemakers, left atrial | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33230 | below: appendage closure [LAAC] | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33231 | below: appendage closure [LAAC] | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33233 | below: appendage closure [LAAC] | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33234 | below: appendage closure [LAAC] | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33235 | • Cohere Health’s portal defibrillators [implantable | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33240 | • Cohere Health’s portal defibrillators [implantable | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33241 | • Cohere Health’s portal defibrillators [implantable | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33244 | • Cohere Health’s portal defibrillators [implantable | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33249 | (online): and subcutaneous] and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33262 | (online): and subcutaneous] and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33263 | (online): and subcutaneous] and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33264 | (online): and subcutaneous] and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33270 | • Information and to cardiac resynchronization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33271 | • Information and to cardiac resynchronization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33272 | • Information and to cardiac resynchronization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33273 | • Information and to cardiac resynchronization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33274 | request a new account therapy) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33275 | request a new account therapy) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33276 | Surgery for obstructive sleep | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33277 | Surgery for obstructive sleep | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33278 | apnea | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33279 | apnea | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33280 | apnea | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33281 | 41512, 41530, 41599, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33285 | Internal loop recorders | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33286 | Internal loop recorders | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33287 | 41512, 41530, 41599, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33288 | 41512, 41530, 41599, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33289 | request a new account therapy) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33340 | request a new account therapy) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33361 | request a new account Transcatheter valve surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33362 | request a new account Transcatheter valve surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33363 | request a new account Transcatheter valve surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33364 | • Additional provider (TMVR, TAVR/TAVI and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33365 | • Additional provider (TMVR, TAVR/TAVI and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33366 | • Additional provider (TMVR, TAVR/TAVI and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33418 | information MitraClip) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33875 | Cardiac devices Aortic repair | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33877 | Cardiac devices Aortic repair | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33880 | Cardiac devices Aortic repair | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33881 | The following services will now be 34701, 34702, 34703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33882 | The following services will now be 34701, 34702, 34703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33883 | The following services will now be 34701, 34702, 34703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33886 | The following services will now be 34701, 34702, 34703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33927 | 33928, 33929, 33935, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33928 | 33945, 38205, 38206, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33929 | 33945, 38205, 38206, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33935 | 33945, 38205, 38206, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33945 | 38230, 38232, 38240, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33975 | Ventricular assist devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33976 | Ventricular assist devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33979 | Ventricular assist devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33981 | Wearable cardioverter K0606 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33982 | Wearable cardioverter K0606 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33983 | Wearable cardioverter K0606 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33990 | Ventricular assist devices Percutaneous ventricular | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33991 | Ventricular assist devices Percutaneous ventricular | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 33995 | Ventricular assist devices Percutaneous ventricular | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34701 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34702 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34703 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34704 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34705 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34706 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34830 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34831 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34832 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34841 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34842 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34843 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34844 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34845 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34846 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34847 | Prior authorization requests for 0995T | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 34848 | Prior authorization requests for 0995T | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 35301 | Carotid revascularization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36245 | Peripheral angiography | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36246 | Peripheral angiography | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36247 | Peripheral angiography | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36465 | Varicose vein: surgical | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36466 | Varicose vein: surgical | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36468 | Varicose vein: surgical | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36470 | treatment and sclerotherapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36471 | treatment and sclerotherapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36473 | treatment and sclerotherapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36474 | 36478, 36479, 36482, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36475 | 36478, 36479, 36482, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36476 | 36478, 36479, 36482, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36478 | 36483, 37700, 37718, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36479 | 36483, 37700, 37718, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36482 | 36483, 37700, 37718, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 36483 | 37722, 37735, 37760, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37215 | Carotid revascularization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37216 | Carotid revascularization | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37217 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37218 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37236 | The following services will now be 37258, 37260, 37262, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37238 | The following services will now be 37258, 37260, 37262, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37242 | below: , ((Only for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37243 | below: , ((Only for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37254 | The following services will now be 37258, 37260, 37262, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37256 | The following services will now be 37258, 37260, 37262, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37258 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37260 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37262 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37263 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37265 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37267 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37269 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37271 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37273 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37275 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37277 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37279 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37280 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37282 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37284 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37286 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37288 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37290 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37292 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37294 | Prior authorization requests for C9764, C9765, C9766, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37296 | Prior authorization requests for C9764, C9765, C9766, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37298 | Prior authorization requests for C9764, C9765, C9766, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37700 | 37722, 37735, 37760, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37718 | 37722, 37735, 37760, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37722 | 37761, 37765, 37766, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37735 | 37761, 37765, 37766, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37760 | 37761, 37765, 37766, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37761 | 37780, 37785, 0524T | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37765 | 37780, 37785, 0524T | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37766 | 37780, 37785, 0524T | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37780 | Ventricular assist devices Percutaneous ventricular 33990, 33991, 33995 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 37785 | Ventricular assist devices Percutaneous ventricular 33990, 33991, 33995 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38205 | 38230, 38232, 38240, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38206 | 38230, 38232, 38240, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38225 | Cellular (including chimeric | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38226 | Cellular (including chimeric | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38227 | Cellular (including chimeric | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38228 | antigen receptor T-cell therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38230 | 38241, 38243, 44135, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38232 | 38241, 38243, 44135, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38240 | 38241, 38243, 44135, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38241 | 47133, 47135, 48160, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38243 | 47133, 47135, 48160, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 38999 | antigen receptor T-cell therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 40512 | Lexington, KY -4601 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 41512 | 42140, 42145, 42299, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 41530 | 42140, 42145, 42299, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 41599 | 42140, 42145, 42299, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 42140 | 42950, 64582, 93150, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 42145 | 42950, 64582, 93150, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 42299 | 42950, 64582, 93150, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 42950 | 93151, 93152, 93153, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43235 | Esophagogastroduodenoscopy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43237 | Esophagogastroduodenoscopy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43238 | Esophagogastroduodenoscopy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43239 | (EGD) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43242 | (EGD) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43252 | (EGD) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43253 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43259 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43280 | Laparoscopic hiatal hernia | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43281 | Laparoscopic hiatal hernia | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43282 | Laparoscopic hiatal hernia | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43284 | indications for existing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43290 | Obesity surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43291 | Obesity surgeries | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43631 | 43634, 43644, 43645, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43632 | 43634, 43644, 43645, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43633 | 43634, 43644, 43645, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43634 | 43770, 43771, 43772, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43644 | 43770, 43771, 43772, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43645 | 43770, 43771, 43772, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43647 | Gastric pacing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43648 | Gastric pacing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43770 | 43773, 43774, 43775, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43771 | 43773, 43774, 43775, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43772 | 43773, 43774, 43775, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43773 | 43842, 43843, 43845, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43774 | 43842, 43843, 43845, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43775 | 43842, 43843, 43845, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43842 | 43846, 43847, 43848, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43843 | 43846, 43847, 43848, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43845 | 43846, 43847, 43848, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43846 | 43886, 43887, 43888, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43847 | 43886, 43887, 43888, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43848 | 43886, 43887, 43888, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43881 | Gastric pacing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43882 | Genicular nerve ablation and 64454, 64624 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43886 | 43889, C9785 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43887 | 43889, C9785 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43888 | 43889, C9785 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 43889 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 44135 | 47133, 47135, 48160, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 47133 | 48550, 48554, 48556, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 47135 | 48550, 48554, 48556, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 47370 | Ablation Bone, liver, kidney prostate | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 47371 | cancer and irreversible | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 47380 | cancer and irreversible | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 47381 | cancer and irreversible | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 47382 | electroporation | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 47383 | electroporation | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 47384 | electroporation | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 48160 | 48550, 48554, 48556, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 48550 | 50300, 50320, 50340, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 48554 | 50300, 50320, 50340, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 48556 | 50300, 50320, 50340, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50250 | Evolent, formerly New 50592, 50593, 51721, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50300 | 50360, 50365, 50370, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50320 | 50360, 50365, 50370, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50340 | 50360, 50365, 50370, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50360 | 50547, 0584T, 0585T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50365 | 50547, 0584T, 0585T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50370 | 50547, 0584T, 0585T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50541 | Evolent, formerly New 50592, 50593, 51721, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50542 | Evolent, formerly New 50592, 50593, 51721, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50547 | 0586T, G0341, G0342, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50592 | Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 50593 | Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 51721 | Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 52597 | Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 53850 | Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 53852 | Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 53854 | all preauthorization requests | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 53865 | indications for existing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 53866 | technology | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 54405 | Penile implant | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55801 | Prostate surgeries Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55810 | Prostate surgeries Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55812 | Prostate surgeries Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55815 | (prostatectomy) Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55821 | (prostatectomy) Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55831 | (prostatectomy) Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55840 | all preauthorization requests | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55842 | all preauthorization requests | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55845 | all preauthorization requests | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55866 | Requests can be submitted | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55867 | on Evolent’s website | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55868 | Requests can be submitted | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55869 | Requests can be submitted | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55873 | all preauthorization requests | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55877 | Requests can be submitted | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55880 | or by calling Evolent at | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55881 | all preauthorization requests | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 55882 | Requests can be submitted | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 60699 | antigen receptor T-cell therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61796 | Radiation therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61798 | Radiation therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61860 | Neurostimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61863 | Neurostimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61867 | Neurostimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61885 | 61891, 61892, 64553, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61886 | 61891, 61892, 64553, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61889 | 61891, 61892, 64553, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61891 | 64555, 64561, 64566, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 61892 | 64555, 64561, 64566, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62287 | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62320 | Epidural injections (outpatient | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62321 | Epidural injections (outpatient | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62322 | Epidural injections (outpatient | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62323 | only) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62324 | Pain infusion pump | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62325 | Pain infusion pump | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62326 | Pain infusion pump | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62327 | The following services will now be 62360, 62361, 62362, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62330 | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62331 | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62350 | The following services will now be 62360, 62361, 62362, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62351 | The following services will now be 62360, 62361, 62362, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62360 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62361 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62362 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 62380 | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63001 | Expedited/urgent cases can be 63011, 63012, 63015, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63003 | Expedited/urgent cases can be 63011, 63012, 63015, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63005 | Expedited/urgent cases can be 63011, 63012, 63015, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63011 | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63012 | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63015 | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63016 | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63017 | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63020 | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63030 | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63032 | Cohere Health portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63035 | Cohere Health portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63040 | 63044, 63045, 63046, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63042 | 63044, 63045, 63046, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63043 | 63044, 63045, 63046, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63044 | 63047, 63048, 63050, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63045 | 63047, 63048, 63050, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63046 | 63047, 63048, 63050, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63047 | 63051, 63052, 63053, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63048 | 63051, 63052, 63053, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63050 | 63051, 63052, 63053, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63051 | 63055, 63056, 63057, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63052 | 63055, 63056, 63057, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63053 | 63055, 63056, 63057, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63055 | 63064, 63066, 63075, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63056 | 63064, 63066, 63075, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63057 | 63064, 63066, 63075, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63064 | 63076, 63077, 63078, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63066 | 63076, 63077, 63078, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63075 | 63076, 63077, 63078, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63076 | 63081, 63082, 63085, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63077 | 63081, 63082, 63085, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63078 | 63081, 63082, 63085, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63081 | 63086, 63087, 63088, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63082 | 63086, 63087, 63088, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63085 | 63086, 63087, 63088, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63086 | 63090, 63091, 63101, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63087 | 63090, 63091, 63101, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63088 | 63090, 63091, 63101, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63090 | 63102, 63103, 63170, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63091 | 63102, 63103, 63170, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63101 | 63102, 63103, 63170, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63102 | 63172, 63173, 63185, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63103 | 63172, 63173, 63185, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63170 | 63172, 63173, 63185, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63172 | 63190, 63191, 63197, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63173 | 63190, 63191, 63197, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63185 | 63190, 63191, 63197, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63190 | 63200, 63250, 63251, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63191 | 63200, 63250, 63251, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63197 | 63200, 63250, 63251, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63200 | 63252, 63265, 63266, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63250 | 63252, 63265, 63266, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63251 | 63252, 63265, 63266, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63252 | 63267, 63268, 63270, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63265 | 63267, 63268, 63270, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63266 | 63267, 63268, 63270, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63267 | 63271, 63272, 63273, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63268 | 63271, 63272, 63273, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63270 | 63271, 63272, 63273, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63271 | 63275, 63276, 63277, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63272 | 63275, 63276, 63277, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63273 | 63275, 63276, 63277, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63275 | 63278, 63280, 63281, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63276 | 63278, 63280, 63281, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63277 | 63278, 63280, 63281, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63278 | 63282, 63283, 63285, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63280 | 63282, 63283, 63285, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63281 | 63282, 63283, 63285, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63282 | 63286, 63287, 63290, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63283 | 63286, 63287, 63290, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63285 | 63286, 63287, 63290, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63286 | 63295, 63300, 63301, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63287 | 63295, 63300, 63301, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63290 | 63295, 63300, 63301, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63295 | 63302, 63303, 63304, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63300 | 63302, 63303, 63304, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63301 | 63302, 63303, 63304, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63302 | 63305, 63306, 63307, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63303 | 63305, 63306, 63307, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63304 | 63305, 63306, 63307, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63305 | 63308, 64628, 64629, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63306 | 63308, 64628, 64629, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63307 | 63308, 64628, 64629, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63308 | 0095T, 0098T, 0164T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63620 | Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63650 | Spinal cord stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63655 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63663 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63664 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63685 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 63688 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64454 | Genicular nerve ablation and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64479 | only) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64480 | only) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64483 | Esophagogastroduodenoscopy 43235, 43237, 43238, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64484 | Esophagogastroduodenoscopy 43235, 43237, 43238, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64490 | Facet injections | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64491 | Facet injections | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64492 | Facet injections | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64493 | 64633, 64634, 64635, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64494 | 64633, 64634, 64635, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64495 | 64633, 64634, 64635, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64553 | 64555, 64561, 64566, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64555 | 64567, 64568, 64575, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64561 | 64567, 64568, 64575, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64566 | 64567, 64568, 64575, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64567 | 64581, 64590, 64596, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64568 | 64581, 64590, 64596, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64575 | 64581, 64590, 64596, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64581 | 64597, 64598, 0587T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64582 | 93151, 93152, 93153, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64590 | Genicular nerve ablation and 64454, 64624 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64596 | 64597, 64598, 0587T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64597 | 0588T, 0783T, 0786T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64598 | 0588T, 0783T, 0786T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64624 | Genicular nerve ablation and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64625 | Radiofrequency ablation for the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64628 | 0095T, 0098T, 0164T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64629 | 0095T, 0098T, 0164T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64633 | 64636, 64999, 0213T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64634 | 64636, 64999, 0213T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64635 | 64636, 64999, 0213T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64636 | 0214T, 0215T, 0216T, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64654 | Implantable Carotid Sinus | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64655 | Implantable Carotid Sinus | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64656 | Implantable Carotid Sinus | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64657 | Implantable Carotid Sinus | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64658 | Stimulator | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64659 | Stimulator | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64721 | Decompression of peripheral | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64728 | Decompression of peripheral | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 64999 | Esophagogastroduodenoscopy 43235, 43237, 43238, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 66989 | Micro-Invasive Glaucoma Surgery | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 66991 | Micro-Invasive Glaucoma Surgery | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67900 | 67904, 67908, 67909, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67903 | 67904, 67908, 67909, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67904 | 67911, 67914, 67916, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67908 | 67911, 67914, 67916, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67909 | 67911, 67914, 67916, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67911 | 67917, 67921, 67923, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67914 | 67917, 67921, 67923, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67916 | 67917, 67921, 67923, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67917 | 67924, 67950 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67921 | 67924, 67950 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67923 | 67924, 67950 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67924 | Bone growth stimulators E0747, E0748, E0760 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 67950 | Bone growth stimulators E0747, E0748, E0760 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 69705 | Therapy (physical and The following services will now 97010, 97012, 97014, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 69706 | Therapy (physical and The following services will now 97010, 97012, 97014, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70336 | Magnetic resonance imaging | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70460 | Diagnostic/cardiac imaging Notification Required | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70470 | Diagnostic/cardiac imaging Notification Required | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70471 | Diagnostic/cardiac imaging Notification Required | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70481 | Diagnostic/cardiac imaging Notification Required | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70482 | Computed tomography (CT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70487 | Computed tomography (CT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70488 | The following services will now be scan | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70491 | The following services will now be scan | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70492 | The following services will now be scan | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70496 | The following services will now be scan | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70498 | managed by Cohere Health®. Magnetic resonance imaging | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70540 | managed by Cohere Health®. Magnetic resonance imaging | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70542 | managed by Cohere Health®. Magnetic resonance imaging | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70543 | Magnetic resonance imaging | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70544 | • Phone: 833-283-0033, Magnetic resonance | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70545 | • Phone: 833-283-0033, Magnetic resonance | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70546 | • Phone: 833-283-0033, Magnetic resonance | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70547 | Monday – Friday, angiography (MRA) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70548 | Monday – Friday, angiography (MRA) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70549 | Monday – Friday, angiography (MRA) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70551 | Please submit authorizations on (MRI) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70552 | Please submit authorizations on (MRI) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70553 | Please submit authorizations on (MRI) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70554 | Magnetic resonance imaging | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 70555 | (MRI) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 71260 | Computed tomography (CT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 71270 | Computed tomography (CT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 71275 | Computed tomography (CT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 71550 | (MRI) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 71551 | (MRI) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 71552 | 72146, 72147, 72148, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 71555 | 8 a.m. – 8 p.m., Eastern | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72126 | Prior authorization requests for scan | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72127 | Prior authorization requests for scan | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72130 | Prior authorization requests for scan | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72132 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72133 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72141 | 72146, 72147, 72148, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72142 | 72146, 72147, 72148, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72146 | 72149, 72156, 72157, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72147 | 72149, 72156, 72157, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72148 | 72149, 72156, 72157, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72149 | 72158, 72195, 72196, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72156 | 72158, 72195, 72196, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72157 | 72158, 72195, 72196, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72158 | surgery) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72159 | 8 a.m. – 8 p.m., Eastern | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72191 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72193 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72194 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72195 | surgery) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72196 | surgery) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72197 | 73223, 73721, 73722, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 72198 | 8 a.m. – 8 p.m., Eastern | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73206 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73218 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73219 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73220 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73221 | 73223, 73721, 73722, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73222 | 73223, 73721, 73722, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73223 | 73723, 74181, 74182, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73225 | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73706 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73718 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73719 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73720 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73721 | 73723, 74181, 74182, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73722 | 73723, 74181, 74182, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73723 | 74183, 75557, 75559, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 73725 | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74160 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74170 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74174 | • Cohere Health’s portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74175 | • Cohere Health’s portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74177 | (online): 75573, 75574, 75635 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74178 | (online): 75573, 75574, 75635 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74181 | 74183, 75557, 75559, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74182 | 74183, 75557, 75559, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74183 | 75561, 75563, 77046, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 74185 | time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 75557 | 75561, 75563, 77046, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 75559 | 75561, 75563, 77046, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 75561 | 77047, 77048, 77049, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 75563 | 77047, 77048, 77049, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 75572 | (online): 75573, 75574, 75635 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 75573 | (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 75574 | (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 75635 | (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77046 | 77047, 77048, 77049, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77047 | C8903, C8905, C8906, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77048 | C8903, C8905, C8906, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77049 | C8903, C8905, C8906, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77280 | Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77290 | Evolent, formerly New | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77295 | Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77301 | Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77338 | Century Health, will manage | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77371 | all preauthorization requests | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77372 | all preauthorization requests | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77373 | all preauthorization requests | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77387 | eFax number: 213-596-3783 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77402 | Requests can be submitted | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77407 | Requests can be submitted | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77412 | Requests can be submitted | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77423 | on Evolent’s website | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77424 | on Evolent’s website | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77425 | on Evolent’s website | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77436 | or by calling Evolent at | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77437 | or by calling Evolent at | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77438 | or by calling Evolent at | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77439 | 844-926-4528, option 5, for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77520 | 844-926-4528, option 5, for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77522 | 844-926-4528, option 5, for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77523 | Surgical Services. You can | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77525 | Surgical Services. You can | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77750 | Surgical Services. You can | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77761 | speak to a live representative | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77762 | speak to a live representative | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77763 | speak to a live representative | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77767 | Monday – Friday | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77768 | Monday – Friday | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77770 | Monday – Friday | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77771 | 8 a.m. – 8 p.m., Eastern time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77772 | 8 a.m. – 8 p.m., Eastern time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 77778 | 8 a.m. – 8 p.m., Eastern time | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78429 | Positron emission | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78430 | Positron emission | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78431 | Positron emission | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78432 | tomography (PET) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78433 | tomography (PET) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78451 | Myocardial perfusion imaging | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78452 | Myocardial perfusion imaging | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78453 | Nuclear stress test | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78454 | Nuclear stress test | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78459 | tomography (PET) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78466 | Nuclear stress test | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78468 | 78473, 78481, 78483, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78469 | 78473, 78481, 78483, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78472 | 78473, 78481, 78483, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78473 | 93350, 93351, C8928, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78481 | 93350, 93351, C8928, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78483 | 93350, 93351, C8928, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78491 | scan/National Oncologic PET | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78492 | scan/National Oncologic PET | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78494 | Single-photon emission | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78608 | scan/National Oncologic PET | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78811 | Registry (NOPR) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78812 | Registry (NOPR) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78813 | Registry (NOPR) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78814 | Prostate-specific A9587, A9593, A9594, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78815 | Prostate-specific A9587, A9593, A9594, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 78816 | Prostate-specific A9587, A9593, A9594, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81105 | Molecular diagnostic and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81112 | Molecular diagnostic and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81120 | Molecular diagnostic and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81121 | Molecular diagnostic and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81161 | genetic testing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81162 | genetic testing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81163 | genetic testing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81165 | 81175, 81176, 81177, 81178, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81166 | 81175, 81176, 81177, 81178, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81167 | 81175, 81176, 81177, 81178, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81168 | 81175, 81176, 81177, 81178, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81175 | 81179, 81180, 81181, 81182, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81176 | 81179, 81180, 81181, 81182, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81177 | 81179, 81180, 81181, 81182, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81178 | 81179, 81180, 81181, 81182, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81179 | 81183, 81184, 81185, 81187, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81180 | 81183, 81184, 81185, 81187, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81181 | 81183, 81184, 81185, 81187, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81182 | 81183, 81184, 81185, 81187, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81183 | 81189, 81191, 81192, 81193, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81184 | 81189, 81191, 81192, 81193, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81185 | 81189, 81191, 81192, 81193, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81187 | 81189, 81191, 81192, 81193, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81189 | 81194, 81195, 81200, 81201, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81191 | 81194, 81195, 81200, 81201, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81192 | 81194, 81195, 81200, 81201, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81193 | 81194, 81195, 81200, 81201, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81194 | 81203, 81204, 81205, 81212, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81195 | 81203, 81204, 81205, 81212, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81200 | 81203, 81204, 81205, 81212, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81201 | 81203, 81204, 81205, 81212, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81203 | 81216, 81218, 81219, 81220, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81204 | 81216, 81218, 81219, 81220, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81205 | 81216, 81218, 81219, 81220, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81212 | 81216, 81218, 81219, 81220, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81216 | 81223, 81225, 81226, 81227, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81218 | 81223, 81225, 81226, 81227, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81219 | 81223, 81225, 81226, 81227, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81220 | 81223, 81225, 81226, 81227, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81223 | 81229, 81230, 81231, 81233, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81225 | 81229, 81230, 81231, 81233, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81226 | 81229, 81230, 81231, 81233, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81227 | 81229, 81230, 81231, 81233, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81229 | 81234, 81236, 81240, 81241, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81230 | 81234, 81236, 81240, 81241, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81231 | 81234, 81236, 81240, 81241, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81233 | 81234, 81236, 81240, 81241, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81234 | 81242, 81243, 81244, 81247, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81236 | 81242, 81243, 81244, 81247, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81240 | 81242, 81243, 81244, 81247, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81241 | 81242, 81243, 81244, 81247, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81242 | 81249, 81250, 81251, 81255, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81243 | 81249, 81250, 81251, 81255, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81244 | 81249, 81250, 81251, 81255, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81247 | 81249, 81250, 81251, 81255, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81249 | 81257, 81259, 81260, 81265, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81250 | 81257, 81259, 81260, 81265, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81251 | 81257, 81259, 81260, 81265, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81255 | 81257, 81259, 81260, 81265, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81257 | 81266, 81269, 81272, 81273, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81259 | 81266, 81269, 81272, 81273, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81260 | 81266, 81269, 81272, 81273, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81265 | 81266, 81269, 81272, 81273, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81266 | 81275, 81276, 81277, 81278, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81269 | 81275, 81276, 81277, 81278, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81272 | 81275, 81276, 81277, 81278, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81273 | 81275, 81276, 81277, 81278, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81275 | 81279, 81283, 81284, 81286, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81276 | 81279, 81283, 81284, 81286, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81277 | 81279, 81283, 81284, 81286, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81278 | 81279, 81283, 81284, 81286, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81279 | 81287, 81290, 81291, 81292, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81283 | 81287, 81290, 81291, 81292, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81284 | 81287, 81290, 81291, 81292, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81286 | 81287, 81290, 81291, 81292, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81287 | 81294, 81295, 81297, 81298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81290 | 81294, 81295, 81297, 81298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81291 | 81294, 81295, 81297, 81298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81292 | 81294, 81295, 81297, 81298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81294 | 81300, 81302, 81305, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81295 | 81300, 81302, 81305, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81297 | 81300, 81302, 81305, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81298 | 81300, 81302, 81305, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81300 | 81306, 81307, 81308, 81309, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81302 | 81306, 81307, 81308, 81309, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81305 | 81306, 81307, 81308, 81309, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81306 | 81310, 81311, 81312, 81314, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81307 | 81310, 81311, 81312, 81314, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81308 | 81310, 81311, 81312, 81314, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81309 | 81310, 81311, 81312, 81314, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81310 | 81317, 81319, 81320, 81321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81311 | 81317, 81319, 81320, 81321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81312 | 81317, 81319, 81320, 81321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81314 | 81317, 81319, 81320, 81321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81317 | 81323, 81324, 81325, 81328, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81319 | 81323, 81324, 81325, 81328, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81320 | 81323, 81324, 81325, 81328, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81321 | 81323, 81324, 81325, 81328, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81323 | 81329, 81330, 81333, 81334, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81324 | 81329, 81330, 81333, 81334, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81325 | 81329, 81330, 81333, 81334, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81328 | 81329, 81330, 81333, 81334, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81329 | 81335, 81336, 81338, 81339, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81330 | 81335, 81336, 81338, 81339, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81333 | 81335, 81336, 81338, 81339, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81334 | 81335, 81336, 81338, 81339, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81335 | 81343, 81344, 81345, 81347, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81336 | 81343, 81344, 81345, 81347, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81338 | 81343, 81344, 81345, 81347, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81339 | 81343, 81344, 81345, 81347, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81343 | 81348, 81350,81351, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81344 | 81348, 81350,81351, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81345 | 81348, 81350,81351, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81347 | 81348, 81350,81351, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81348 | 81352, 81355, 81357, 81361, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81350 | 81352, 81355, 81357, 81361, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81351 | 81352, 81355, 81357, 81361, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81352 | 81364, 81370, 81371, 81372, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81354 | 81430, 81431, 81432, 81434, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81355 | 81364, 81370, 81371, 81372, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81357 | 81364, 81370, 81371, 81372, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81361 | 81364, 81370, 81371, 81372, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81364 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81370 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81371 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81372 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81373 | 81378, 81379, 81380, 81381, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81375 | 81378, 81379, 81380, 81381, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81376 | 81378, 81379, 81380, 81381, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81377 | 81378, 81379, 81380, 81381, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81378 | 81382, 81383, 81400, 81401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81379 | 81382, 81383, 81400, 81401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81380 | 81382, 81383, 81400, 81401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81381 | 81382, 81383, 81400, 81401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81382 | 81402, 81403, 81404, 81405, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81383 | 81402, 81403, 81404, 81405, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81400 | 81402, 81403, 81404, 81405, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81401 | 81402, 81403, 81404, 81405, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81402 | 81406, 81407, 81408, 81410, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81403 | 81406, 81407, 81408, 81410, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81404 | 81406, 81407, 81408, 81410, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81405 | 81406, 81407, 81408, 81410, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81406 | 81411, 81412, 81413, 81414, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81407 | 81411, 81412, 81413, 81414, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81408 | 81411, 81412, 81413, 81414, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81410 | 81411, 81412, 81413, 81414, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81411 | 81415, 81416, 81418, 81419, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81412 | 81415, 81416, 81418, 81419, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81413 | 81415, 81416, 81418, 81419, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81414 | 81415, 81416, 81418, 81419, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81415 | 81354, 81422, 81425, 81426, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81416 | 81354, 81422, 81425, 81426, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81418 | 81354, 81422, 81425, 81426, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81419 | 81354, 81422, 81425, 81426, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81422 | 81430, 81431, 81432, 81434, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81425 | 81430, 81431, 81432, 81434, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81426 | 81430, 81431, 81432, 81434, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81430 | 81435, 81437, 81439, 81440, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81431 | 81435, 81437, 81439, 81440, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81432 | 81435, 81437, 81439, 81440, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81434 | 81435, 81437, 81439, 81440, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81435 | 81443, 81445, 81448, 81449, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81437 | 81443, 81445, 81448, 81449, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81439 | 81443, 81445, 81448, 81449, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81440 | 81443, 81445, 81448, 81449, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81443 | 81450, 81451, 81455, 81456, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81445 | 81450, 81451, 81455, 81456, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81448 | 81450, 81451, 81455, 81456, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81449 | 81450, 81451, 81455, 81456, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81450 | 81457, 81458, 81459, 81460, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81451 | 81457, 81458, 81459, 81460, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81455 | 81457, 81458, 81459, 81460, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81456 | 81457, 81458, 81459, 81460, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81457 | 81462, 81463,81464, 81465, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81458 | 81462, 81463,81464, 81465, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81459 | 81462, 81463,81464, 81465, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81460 | 81462, 81463,81464, 81465, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81462 | 81471, 81479, 81490, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81463 | 81471, 81479, 81490, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81464 | 81471, 81479, 81490, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81465 | 81471, 81479, 81490, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81471 | 81503, 81518, 81519, 81520, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81479 | 81503, 81518, 81519, 81520, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81490 | 81503, 81518, 81519, 81520, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81503 | 81521, 81522, 81524, 81525, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81518 | 81521, 81522, 81524, 81525, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81519 | 81521, 81522, 81524, 81525, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81520 | 81521, 81522, 81524, 81525, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81521 | 81529, 81540, 81546, 81554, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81522 | 81529, 81540, 81546, 81554, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81524 | 81529, 81540, 81546, 81554, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81525 | 81529, 81540, 81546, 81554, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81529 | 81558, 81595, 81599, 83080, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81540 | 81558, 81595, 81599, 83080, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81546 | 81558, 81595, 81599, 83080, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81554 | 81558, 81595, 81599, 83080, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81558 | 0005U, 0020M, 0026U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81595 | 0005U, 0020M, 0026U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 81599 | 0005U, 0020M, 0026U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 83080 | 0005U, 0020M, 0026U, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 90867 | Transcranial magnetic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 90868 | Transcranial magnetic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 90869 | Transcranial magnetic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 91110 | Capsule endoscopy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 91111 | Capsule endoscopy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 91113 | Capsule endoscopy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 92920 | Prior authorization requests for Coronary angioplasty/stent | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 92924 | Prior authorization requests for Coronary angioplasty/stent | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 92928 | Prior authorization requests for Coronary angioplasty/stent | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 92930 | Prior authorization requests for Coronary angioplasty/stent | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 92933 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 92937 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 92943 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 92945 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 92972 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93145 | Stimulator | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93146 | Stimulator | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93150 | 93151, 93152, 93153, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93151 | C9727 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93152 | C9727 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93153 | C9727 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93228 | Wearable cardiac | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93229 | Wearable cardiac | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93264 | • Additional provider | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93312 | Transesophageal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93313 | Transesophageal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93314 | Transesophageal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93315 | echocardiogram (TEE) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93316 | echocardiogram (TEE) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93317 | echocardiogram (TEE) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93318 | C8926, C8927 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93350 | C8930 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93351 | C8930 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93355 | C8926, C8927 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93451 | Cardiac procedures/surgeries Cardiac catheterizations | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93452 | Cardiac procedures/surgeries Cardiac catheterizations | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93453 | Cardiac procedures/surgeries Cardiac catheterizations | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93454 | The following services will now be 93457, 93458, 93459, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93455 | The following services will now be 93457, 93458, 93459, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93456 | The following services will now be 93457, 93458, 93459, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93457 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93458 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93459 | The following services will now be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93460 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93461 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93580 | Patent foramen ovale | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93593 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93594 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93595 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93596 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93597 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93600 | Electrophysiology study (EPS) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93602 | Electrophysiology study (EPS) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93603 | Electrophysiology study (EPS) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93610 | or EPS with 3D mapping | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93612 | or EPS with 3D mapping | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93618 | or EPS with 3D mapping | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93619 | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93620 | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93631 | information | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93640 | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93641 | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93642 | • Portal login (prior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93644 | authorization request) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93650 | Cardiac | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93653 | Cardiac | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93654 | Cardiac | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 93656 | ablation/electrophysiology | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 95807 | Facility-based sleep studies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 95808 | Facility-based sleep studies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 95810 | Facility-based sleep studies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 95811 | (PSG) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96112 | Neuropsychological testing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96113 | Neuropsychological testing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96116 | Neuropsychological testing | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96121 | 96132, 96133, 96136, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96130 | 96132, 96133, 96136, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96131 | 96132, 96133, 96136, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96132 | 96137, 96138, 96139, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96133 | 96137, 96138, 96139, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96136 | 96137, 96138, 96139, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96137 | 96146 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96138 | 96146 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96139 | 96146 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 96146 | Surgical Services. You can | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97010 | Therapy (physical and The following services will now | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97012 | Therapy (physical and The following services will now | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97014 | Therapy (physical and The following services will now | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97016 | occupational) be managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97018 | occupational) be managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97022 | occupational) be managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97024 | Health®. Please submit | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97026 | Health®. Please submit | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97028 | Health®. Please submit | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97032 | authorizations on Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97033 | authorizations on Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97034 | authorizations on Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97035 | Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97036 | Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97037 | Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97039 | registered, please register | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97110 | registered, please register | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97112 | registered, please register | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97113 | 97129, 97130, 97139, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97116 | 97129, 97130, 97139, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97124 | 97129, 97130, 97139, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97129 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97130 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97139 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97140 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97150 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97153 | Behavioral health services Applied behavior analysis | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97154 | Behavioral health services Applied behavior analysis | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97155 | Behavioral health services Applied behavior analysis | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97156 | Behavioral health services Applied behavior analysis | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97157 | (ABA) /adaptive behavior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97158 | (ABA) /adaptive behavior | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97164 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97168 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97530 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97533 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97535 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97537 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97542 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97545 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97546 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97550 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97551 | • Cohere Health’s | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97552 | • Cohere Health’s | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97605 | Negative pressure wound therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97606 | Negative pressure wound therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97750 | • Cohere Health’s | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97755 | portal (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97760 | portal (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97761 | portal (online) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97763 | • Information and to | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 97799 | • Information and to | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 99183 | Hyperbaric therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 99199 | Transplant Evaluation – | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 99512 | Home Health (managed by One | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| 99600 | Home Health (managed by One | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2001 | Skin and tissue substitutes | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2002 | Skin and tissue substitutes | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2004 | Skin and tissue substitutes | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2005 | A2008, A2009, A2010, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2006 | A2008, A2009, A2010, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2007 | A2008, A2009, A2010, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2008 | A2011, A2012, A2013, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2009 | A2011, A2012, A2013, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2010 | A2011, A2012, A2013, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2011 | A2014, A2015, A2016, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2012 | A2014, A2015, A2016, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2013 | A2014, A2015, A2016, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2014 | A2017, A2018, A2019, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2015 | A2017, A2018, A2019, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2016 | A2017, A2018, A2019, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2017 | A2020, A2021, A2022, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2018 | A2020, A2021, A2022, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2019 | A2020, A2021, A2022, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2020 | A2023, A2024, A2025, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2021 | A2023, A2024, A2025, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2022 | A2023, A2024, A2025, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2023 | A2026, A2027, A2028, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2024 | A2026, A2027, A2028, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2025 | A2026, A2027, A2028, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2026 | A2029, A2030, A2031, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2027 | A2029, A2030, A2031, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2028 | A2029, A2030, A2031, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2029 | A2032, A2033, A2034, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2030 | A2032, A2033, A2034, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2031 | A2032, A2033, A2034, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2032 | A2035, A2036, A2037, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2033 | A2035, A2036, A2037, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2034 | A2035, A2036, A2037, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2035 | A2038, A2039, A4100, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2036 | A2038, A2039, A4100, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2037 | A2038, A2039, A4100, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2038 | C1832, C8002, C9354, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A2039 | C1832, C8002, C9354, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A4100 | C1832, C8002, C9354, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A4238 | Diabetic Treatment and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A4239 | Diabetic Treatment and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A4593 | Neuromuscular stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A4594 | Neuromuscular stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A6550 | Negative pressure wound therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9274 | Diabetic Treatment and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9282 | L5010, L5020, L5050, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9587 | Prostate-specific | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9593 | Prostate-specific | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9594 | Prostate-specific | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9595 | membrane antigen | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9596 | membrane antigen | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9597 | membrane antigen | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9608 | (PSMA/PET CT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9611 | (PSMA/PET CT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9616 | (PSMA/PET CT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| A9800 | Single-photon emission 78494 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1605 | C1722, C1777, C1779, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1607 | C1787, C1826, C1827, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1721 | C1722, C1777, C1779, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1722 | C1785, C1786, C1824, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1735 | E0739 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1736 | E0739 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1761 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1767 | C1787, C1826, C1827, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1772 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1777 | C1785, C1786, C1824, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1779 | C1785, C1786, C1824, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1785 | C1882, C1895, C1896, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1786 | C1882, C1895, C1896, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1787 | C9807, E0721, E0734, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1789 | cancer) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1816 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1820 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1821 | C2614, C9757 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1822 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1824 | C1882, C1895, C1896, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1825 | Internal loop recorders 33285, 33286 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1826 | C9807, E0721, E0734, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1827 | C9807, E0721, E0734, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1832 | C9358, C9360, C9361, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1882 | C1898, C1899, C1900, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1891 | managed by Cohere Health® | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1895 | C1898, C1899, C1900, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1896 | C1898, C1899, C1900, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1898 | C2619, C2620, C2621, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1899 | C2619, C2620, C2621, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C1900 | C2619, C2620, C2621, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C2614 | Surgery for obstructive sleep 21685, 33276, 33277, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C2619 | C2624, G0555 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C2620 | C2624, G0555 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C2621 | C2624, G0555 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C2624 | Implantable Carotid Sinus 64654, 64655, 64656, 64657, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C2626 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C7571 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8002 | C9358, C9360, C9361, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8003 | request a new account | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8900 | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8901 | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8902 | • Fax: 857-557-6787 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8903 | C8908,C9762, C9763, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8905 | C8908,C9762, C9763, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8906 | C8908,C9762, C9763, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8908 | C9791 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8909 | Expedited/urgent cases can be C8912, C8913, C8914, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8910 | Expedited/urgent cases can be C8912, C8913, C8914, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8911 | Expedited/urgent cases can be C8912, C8913, C8914, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8912 | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8913 | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8914 | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8918 | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8919 | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8920 | submitted and monitored on the | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8925 | C8926, C8927 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8926 | Durable medical equipment Airway Clearance Devices E0469, E0481, E0482 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8927 | Durable medical equipment Airway Clearance Devices E0469, E0481, E0482 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8928 | C8930 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8930 | Peripheral angiography 36245, 36246, 36247 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8931 | Cohere Health portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8932 | Cohere Health portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8933 | Cohere Health portal | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8934 | Magnetic resonance imaging 70336, 70543, 70554, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8935 | Magnetic resonance imaging 70336, 70543, 70554, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C8936 | Magnetic resonance imaging 70336, 70543, 70554, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9354 | C9358, C9360, C9361, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9358 | C9363, C9364, Q4101, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9360 | C9363, C9364, Q4101, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9361 | C9363, C9364, Q4101, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9363 | Q4102, Q4103, Q4104, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9364 | Q4102, Q4103, Q4104, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9399 | [CAR T]), genetic, tissue and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9600 | submitted using the options | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9602 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9604 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9607 | below | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9727 | Surgical nasal/sinus Excludes diagnostic 31237, 31240, 31242, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9757 | Surgery for obstructive sleep 21685, 33276, 33277, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9762 | C9791 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9763 | C9791 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9764 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9765 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9766 | Prior authorization requests for | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9767 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9772 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9773 | services managed by Cohere | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9774 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9775 | Health. Requests can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9781 | request a new account | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9785 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9791 | Myocardial perfusion imaging 78451, 78452 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9804 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9806 | Please submit authorizations on | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| C9807 | E0735, E0736, E0737, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0193 | Hospital beds and accessories | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0194 | Hospital beds and accessories | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0265 | Hospital beds and accessories | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0266 | E0277, E0301, E0302, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0277 | E0303, E0304. | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0296 | E0277, E0301, E0302, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0297 | E0277, E0301, E0302, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0301 | E0303, E0304. | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0302 | E0303, E0304. | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0303 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0304 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0466 | Noninvasive home ventilators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0468 | Noninvasive home ventilators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0469 | Durable medical equipment Airway Clearance Devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0481 | Durable medical equipment Airway Clearance Devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0482 | Durable medical equipment Airway Clearance Devices | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0483 | High-frequency chest | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0486 | Obstructive Sleep Apnea | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0490 | Obstructive Sleep Apnea | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0491 | Obstructive Sleep Apnea | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0492 | Non-Surgical Treatments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0493 | Non-Surgical Treatments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0650 | Pneumatic Compression | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0651 | Pneumatic Compression | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0652 | Pneumatic Compression | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0658 | E0665, E0666, E0667, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0659 | E0665, E0666, E0667, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0660 | E0665, E0666, E0667, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0665 | E0668, E0669, E0670, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0666 | E0668, E0669, E0670, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0667 | E0668, E0669, E0670, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0668 | E0671, E0672, E0673, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0669 | E0671, E0672, E0673, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0670 | E0671, E0672, E0673, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0671 | E0675, E0676, E0677, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0672 | E0675, E0676, E0677, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0673 | E0675, E0676, E0677, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0675 | E0678, E0679, E0680, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0676 | E0678, E0679, E0680, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0677 | E0678, E0679, E0680, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0678 | E0681, E0682, E0683 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0679 | E0681, E0682, E0683 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0680 | E0681, E0682, E0683 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0681 | Unlisted DME K0900 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0682 | Unlisted DME K0900 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0683 | Unlisted DME K0900 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0691 | UV Light Therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0692 | UV Light Therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0693 | UV Light Therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0694 | UV Light Therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0721 | E0735, E0736, E0737, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0732 | Transcranial magnetic | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0734 | E0735, E0736, E0737, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0735 | E0743, L8683 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0736 | E0743, L8683 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0737 | E0743, L8683 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0738 | E0739 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0739 | Epidural injections (outpatient 62320, 62321, 62322, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0743 | Noninvasive home ventilators E0466, E0468 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0747 | Bone growth stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0748 | Bone growth stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0760 | Bone growth stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0762 | Electrical Stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0764 | Neuromuscular stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0766 | Electrical Stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0770 | Neuromuscular stimulators | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0782 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0783 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0784 | Supplies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0785 | Cohere Health's website. If not | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0786 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E0986 | Wheelchairs/scooters | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1002 | Wheelchairs/scooters | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1003 | Wheelchairs/scooters | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1004 | E1007, E1008, E1009, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1005 | E1007, E1008, E1009, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1006 | E1007, E1008, E1009, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1007 | E1010, E1012, E1161, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1008 | E1010, E1012, E1161, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1009 | E1010, E1012, E1161, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1010 | E1220, E1234, E1235, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1012 | E1220, E1234, E1235, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1161 | E1220, E1234, E1235, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1220 | E1239, E2207, E2298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1234 | E1239, E2207, E2298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1235 | E1239, E2207, E2298, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E1239 | E2310, E2311, E2312, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2102 | Supplies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2103 | Supplies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2207 | E2310, E2311, E2312, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2298 | E2310, E2311, E2312, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2310 | E2321, E2322, E2325, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2311 | E2321, E2322, E2325, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2312 | E2321, E2322, E2325, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2321 | 02WA4QZ | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2322 | 02WA4QZ | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2325 | 02WA4QZ | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2327 | E2330, E2331, E2343, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2328 | E2330, E2331, E2343, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2329 | E2330, E2331, E2343, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2330 | E2351, E2358, E2359, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2331 | E2351, E2358, E2359, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2343 | E2351, E2358, E2359, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2351 | E2360, E2362, E2364, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2358 | E2360, E2362, E2364, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2359 | E2360, E2362, E2364, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2360 | E2368, E2369, E2375, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2362 | E2368, E2369, E2375, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2364 | E2368, E2369, E2375, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2368 | E2376, E2383, E2398, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2369 | E2376, E2383, E2398, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2375 | E2376, E2383, E2398, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2376 | K0005, K0008, K0009, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2383 | K0005, K0008, K0009, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2398 | K0005, K0008, K0009, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2402 | (NPWT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2508 | Augmentative and E2599, E3000 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2510 | Augmentative and E2599, E3000 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2511 | Augmentative and E2599, E3000 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E2599 | Augmentative and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| E3000 | Augmentative and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0151 | Home Health (managed by One | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0152 | Home Care) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0153 | Home Care) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0155 | Home Care) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0156 | G0159, G0160, G0161, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0157 | G0159, G0160, G0161, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0158 | G0159, G0160, G0161, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0159 | G0162, G0299, G0300, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0160 | G0162, G0299, G0300, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0161 | G0162, G0299, G0300, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0162 | G0493, G0494, G0495, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0277 | Hyperbaric therapy | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0281 | • Information and to | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0283 | request a new | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0299 | G0493, G0494, G0495, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0300 | G0493, G0494, G0495, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0339 | eFax number: 213-596-3783 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0340 | eFax number: 213-596-3783 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0341 | G0343, L8698, 02WA3QZ, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0342 | G0343, L8698, 02WA3QZ, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0343 | 02WA3QZ | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0458 | eFax email | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0493 | G0496, G2168, G2169, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0494 | G0496, G2168, G2169, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0495 | G0496, G2168, G2169, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0496 | T1000 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G0555 | Implantable Carotid Sinus 64654, 64655, 64656, 64657, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G2168 | T1000 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| G2169 | T1000 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| H0010 | Substance use disorder (SUD) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| H0015 | Intensive outpatient (IOP) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| H0023 | Community support services | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| H0025 | Community support services | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| H0036 | Community support services | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| H0046 | Crisis services H2011, S9445 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| H2011 | Crisis services | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| H2016 | Crisis services H2011, S9445 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| H2033 | Crisis services H2011, S9445 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J3387 | [CAR T]), genetic, tissue and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J3389 | [CAR T]), genetic, tissue and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J3391 | transplant therapies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J3392 | [CAR T]), genetic, tissue and | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J3393 | transplant therapies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J3394 | transplant therapies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J3402 | Q2042, Q2053, Q2054, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J3490 | transplant therapies | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J3590 | Q2042, Q2053, Q2054, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J7330 | request a new account | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| J9999 | Q2042, Q2053, Q2054, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0005 | K0013, K0669, K0800, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0008 | K0013, K0669, K0800, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0009 | K0013, K0669, K0800, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0013 | K0801, K0802, K0806, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0606 | Wearable cardioverter | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0669 | K0801, K0802, K0806, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0743 | (NPWT) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0800 | K0801, K0802, K0806, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0801 | K0807, K0808, K0812, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0802 | K0807, K0808, K0812, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0806 | K0807, K0808, K0812, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0807 | K0813, K0814, K0815, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0808 | K0813, K0814, K0815, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0812 | K0813, K0814, K0815, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0813 | K0816, K0820, K0821, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0814 | K0816, K0820, K0821, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0815 | K0816, K0820, K0821, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0816 | K0822, K0823, K0824, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0820 | K0822, K0823, K0824, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0821 | K0822, K0823, K0824, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0822 | K0825, K0826, K0827, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0823 | K0825, K0826, K0827, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0824 | K0825, K0826, K0827, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0825 | K0828, K0829, K0830, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0826 | K0828, K0829, K0830, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0827 | K0828, K0829, K0830, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0828 | K0831, K0835, K0836, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0829 | K0831, K0835, K0836, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0830 | K0831, K0835, K0836, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0831 | K0837, K0838, K0839, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0835 | K0837, K0838, K0839, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0836 | K0837, K0838, K0839, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0837 | K0840, K0841, K0842, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0838 | K0840, K0841, K0842, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0839 | K0840, K0841, K0842, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0840 | K0843, K0848, K0849, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0841 | K0843, K0848, K0849, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0842 | K0843, K0848, K0849, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0843 | K0850, K0851, K0852, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0848 | K0850, K0851, K0852, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0849 | K0850, K0851, K0852, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0850 | K0853, K0854, K0855, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0851 | K0853, K0854, K0855, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0852 | K0853, K0854, K0855, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0853 | K0856, K0857, K0858, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0854 | K0856, K0857, K0858, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0855 | K0856, K0857, K0858, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0856 | K0859, K0860, K0861, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0857 | K0859, K0860, K0861, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0858 | K0859, K0860, K0861, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0859 | K0862, K0863, K0864, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0860 | K0862, K0863, K0864, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0861 | K0862, K0863, K0864, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0862 | K0868, K0869, K0870, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0863 | K0868, K0869, K0870, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0864 | K0868, K0869, K0870, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0868 | K0871, K0877, K0878, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0869 | K0871, K0877, K0878, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0870 | K0871, K0877, K0878, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0871 | K0879, K0880, K0884, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0877 | K0879, K0880, K0884, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0878 | K0879, K0880, K0884, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0879 | K0885, K0886, K0890, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0880 | K0885, K0886, K0890, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0884 | K0885, K0886, K0890, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0885 | K0891, K0898, K0899 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0886 | K0891, K0898, K0899 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0890 | K0891, K0898, K0899 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0891 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0898 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0899 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K0900 | Unlisted DME | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K1007 | Orthotics | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| K1027 | Non-Surgical Treatments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0452 | Orthotics | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0456 | Orthotics | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0457 | Orthotics | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0458 | L0464, L0480, L0482, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0460 | L0464, L0480, L0482, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0462 | L0464, L0480, L0482, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0464 | L0484, L0486, L0488, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0480 | L0484, L0486, L0488, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0482 | L0484, L0486, L0488, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0484 | L0624, L0629, L0631, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0486 | L0624, L0629, L0631, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0488 | L0624, L0629, L0631, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0624 | L0632, L0634, L0635, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0629 | L0632, L0634, L0635, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0631 | L0632, L0634, L0635, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0632 | L0636, L0637, L0638, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0634 | L0636, L0637, L0638, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0635 | L0636, L0637, L0638, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0636 | L0639, L0640, L0700, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0637 | L0639, L0640, L0700, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0638 | L0639, L0640, L0700, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0639 | L0710, L0720, L0999 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0640 | L0710, L0720, L0999 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0700 | L0710, L0720, L0999 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0710 | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0720 | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L0999 | Expedited/urgent cases can be | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1000 | L1680, L1685, L1686, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1200 | L1680, L1685, L1686, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1499 | L1680, L1685, L1686, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1680 | L1690, L1700, L1730, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1685 | L1690, L1700, L1730, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1686 | L1690, L1700, L1730, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1690 | L1834, L1840, L1843, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1700 | L1834, L1840, L1843, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1730 | L1834, L1840, L1843, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1834 | L1844, L1845, L1846, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1840 | L1844, L1845, L1846, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1843 | L1844, L1845, L1846, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1844 | L1848, L1851, L1852, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1845 | L1848, L1851, L1852, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1846 | L1848, L1851, L1852, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1848 | L1860, L1907, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1851 | L1860, L1907, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1852 | L1860, L1907, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1860 | L1932, L1933, L1945, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1907 | L1932, L1933, L1945, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1932 | L1950, L1951, L1952, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1933 | L1950, L1951, L1952, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1945 | L1950, L1951, L1952, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1950 | L1960, L1970, L2000, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1951 | L1960, L1970, L2000, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1952 | L1960, L1970, L2000, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1960 | L2005, L2006, L2010, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L1970 | L2005, L2006, L2010, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2000 | L2005, L2006, L2010, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2005 | L2020, L2030, L2034, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2006 | L2020, L2030, L2034, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2010 | L2020, L2030, L2034, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2020 | L2036, L2037, L2038, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2030 | L2036, L2037, L2038, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2034 | L2036, L2037, L2038, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2036 | L2106, L2108, L2128, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2037 | L2106, L2108, L2128, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2038 | L2106, L2108, L2128, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2106 | L2136, L2350, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2108 | L2136, L2350, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2128 | L2136, L2350, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2136 | L2525, L2526, L2627, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2350 | L2525, L2526, L2627, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2525 | L2999, L3671, L3674, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2526 | L2999, L3671, L3674, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2627 | L2999, L3671, L3674, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L2999 | L3720, L3730, L3740, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3671 | L3720, L3730, L3740, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3674 | L3720, L3730, L3740, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3720 | L3763, L3764, L3765, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3730 | L3763, L3764, L3765, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3740 | L3763, L3764, L3765, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3763 | L3766, L3900, L3901, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3764 | L3766, L3900, L3901, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3765 | L3766, L3900, L3901, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3766 | L3904, L3905, L3961, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3900 | L3904, L3905, L3961, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3901 | L3904, L3905, L3961, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3904 | L3971, L3973, L3977, L3999, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3905 | L3971, L3973, L3977, L3999, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3961 | L3971, L3973, L3977, L3999, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3971 | L4631, L8701, L8702 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3973 | L4631, L8701, L8702 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3977 | L4631, L8701, L8702 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L3999 | L4631, L8701, L8702 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L4631 | Pain infusion pump 62324, 62325, 62326, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5000 | L5010, L5020, L5050, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5010 | L5060, L5100, L5105, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5020 | L5060, L5100, L5105, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5050 | L5060, L5100, L5105, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5060 | L5150, L5160, L5200, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5100 | L5150, L5160, L5200, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5105 | L5150, L5160, L5200, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5150 | L5210, L5220, L5230, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5160 | L5210, L5220, L5230, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5200 | L5210, L5220, L5230, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5210 | L5250, L5270, L5280, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5220 | L5250, L5270, L5280, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5230 | L5250, L5270, L5280, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5250 | L5301, L5312, L5321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5270 | L5301, L5312, L5321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5280 | L5301, L5312, L5321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5301 | L5331, L5341, L5420, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5312 | L5331, L5341, L5420, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5321 | L5331, L5341, L5420, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5331 | L5500, L5505, L5510, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5341 | L5500, L5505, L5510, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5420 | L5500, L5505, L5510, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5500 | L5520, L5530, L5535, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5505 | L5520, L5530, L5535, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5510 | L5520, L5530, L5535, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5520 | L5540, L5560, L5570, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5530 | L5540, L5560, L5570, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5535 | L5540, L5560, L5570, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5540 | L5580, L5585, L5590, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5560 | L5580, L5585, L5590, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5570 | L5580, L5585, L5590, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5580 | L5595, L5600, L5610, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5585 | L5595, L5600, L5610, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5590 | L5595, L5600, L5610, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5595 | L5611, L5613, L5614, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5600 | L5611, L5613, L5614, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5610 | L5611, L5613, L5614, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5611 | L5615, L5616, L5617, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5613 | L5615, L5616, L5617, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5614 | L5615, L5616, L5617, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5615 | L5618, L5620, L5622, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5616 | L5618, L5620, L5622, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5617 | L5618, L5620, L5622, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5618 | L5624, L5626, L5628, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5620 | L5624, L5626, L5628, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5622 | L5624, L5626, L5628, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5624 | L5629, L5630, L5631, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5626 | L5629, L5630, L5631, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5628 | L5629, L5630, L5631, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5629 | L5632, L5634, L5636, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5630 | L5632, L5634, L5636, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5631 | L5632, L5634, L5636, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5632 | L5637, L5638, L5639, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5634 | L5637, L5638, L5639, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5636 | L5637, L5638, L5639, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5637 | L5640, L5642, L5643, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5638 | L5640, L5642, L5643, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5639 | L5640, L5642, L5643, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5640 | L5644, L5645, L5646, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5642 | L5644, L5645, L5646, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5643 | L5644, L5645, L5646, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5644 | L5647, L5648, L5649, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5645 | L5647, L5648, L5649, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5646 | L5647, L5648, L5649, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5647 | L5650, L5651, L5652, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5648 | L5650, L5651, L5652, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5649 | L5650, L5651, L5652, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5650 | L5653, L5654, L5655, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5651 | L5653, L5654, L5655, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5652 | L5653, L5654, L5655, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5653 | L5656, L5657, L5658, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5654 | L5656, L5657, L5658, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5655 | L5656, L5657, L5658, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5656 | L5661, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5657 | L5661, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5658 | L5661, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5661 | L5665, L5666, L5668, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5665 | L5670, L5671, L5672, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5666 | L5670, L5671, L5672, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5668 | L5670, L5671, L5672, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5670 | L5673, L5676, L5677, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5671 | L5673, L5676, L5677, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5672 | L5673, L5676, L5677, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5673 | L5678, L5679, L5681, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5676 | L5678, L5679, L5681, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5677 | L5678, L5679, L5681, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5678 | L5682, L5683, L5684, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5679 | L5682, L5683, L5684, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5681 | L5682, L5683, L5684, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5682 | L5685, L5686, L5688, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5683 | L5685, L5686, L5688, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5684 | L5685, L5686, L5688, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5685 | L5690, L5692, L5694, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5686 | L5690, L5692, L5694, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5688 | L5690, L5692, L5694, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5690 | L5695, L5696, L5697, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5692 | L5695, L5696, L5697, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5694 | L5695, L5696, L5697, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5695 | L5698, L5699, L5700, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5696 | L5698, L5699, L5700, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5697 | L5698, L5699, L5700, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5698 | L5701, L5702, L5703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5699 | L5701, L5702, L5703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5700 | L5701, L5702, L5703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5701 | L5704, L5705, L5706, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5702 | L5704, L5705, L5706, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5703 | L5704, L5705, L5706, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5704 | L5707, L5710, L5711, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5705 | L5707, L5710, L5711, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5706 | L5707, L5710, L5711, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5707 | L5712, L5714, L5716, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5710 | L5712, L5714, L5716, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5711 | L5712, L5714, L5716, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5712 | L5718, L5722, L5724, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5714 | L5718, L5722, L5724, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5716 | L5718, L5722, L5724, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5718 | L5726, L5728, L5780, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5722 | L5726, L5728, L5780, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5724 | L5726, L5728, L5780, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5726 | L5781, L5782, L5783, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5728 | L5781, L5782, L5783, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5780 | L5781, L5782, L5783, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5781 | L5785, L5790, L5795, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5782 | L5785, L5790, L5795, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5783 | L5785, L5790, L5795, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5785 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5790 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5795 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5810 | L5814, L5816, L5818, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5811 | L5814, L5816, L5818, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5812 | L5814, L5816, L5818, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5814 | L5822, L5824, L5826, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5816 | L5822, L5824, L5826, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5818 | L5822, L5824, L5826, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5822 | L5827, L5828, L5830, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5824 | L5827, L5828, L5830, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5826 | L5827, L5828, L5830, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5827 | L5840, L5841, L5845, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5828 | L5840, L5841, L5845, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5830 | L5840, L5841, L5845, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5840 | L5848, L5850, L5855, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5841 | L5848, L5850, L5855, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5845 | L5848, L5850, L5855, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5848 | L5856, L5857, L5858, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5850 | L5856, L5857, L5858, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5855 | L5856, L5857, L5858, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5856 | L5859, L5910, L5920, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5857 | L5859, L5910, L5920, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5858 | L5859, L5910, L5920, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5859 | L5925, L5926, L5930, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5910 | L5925, L5926, L5930, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5920 | L5925, L5926, L5930, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5925 | L5940, L5950, L5960, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5926 | L5940, L5950, L5960, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5930 | L5940, L5950, L5960, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5940 | L5961, L5962, L5964, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5950 | L5961, L5962, L5964, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5960 | L5961, L5962, L5964, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5961 | L5966, L5968, L5969, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5962 | L5966, L5968, L5969, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5964 | L5966, L5968, L5969, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5966 | L5970, L5971, L5972, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5968 | L5970, L5971, L5972, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5969 | L5970, L5971, L5972, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5970 | L5973, L5974, L5975, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5971 | L5973, L5974, L5975, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5972 | L5973, L5974, L5975, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5973 | L5976, L5978, L5979, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5974 | L5976, L5978, L5979, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5975 | L5976, L5978, L5979, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5976 | L5980, L5981, L5982, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5978 | L5980, L5981, L5982, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5979 | L5980, L5981, L5982, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5980 | L5984, L5985, L5986, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5981 | L5984, L5985, L5986, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5982 | L5984, L5985, L5986, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5984 | L5987, L5988, L5991, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5985 | L5987, L5988, L5991, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5986 | L5987, L5988, L5991, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5987 | L5999, L6026, L6028, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5988 | L5999, L6026, L6028, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5991 | L5999, L6026, L6028, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L5999 | L6029, L6030, L6031, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6026 | L6029, L6030, L6031, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6028 | L6029, L6030, L6031, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6029 | L6032, L6033, L6037, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6030 | L6032, L6033, L6037, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6031 | L6032, L6033, L6037, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6032 | L6050, L6055, L6100, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6033 | L6050, L6055, L6100, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6037 | L6050, L6055, L6100, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6050 | L6110, L6120, L6130, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6055 | L6110, L6120, L6130, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6100 | L6110, L6120, L6130, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6110 | L6200, L6205, L6250, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6120 | L6200, L6205, L6250, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6130 | L6200, L6205, L6250, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6200 | L6300, L6310, L6320, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6205 | L6300, L6310, L6320, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6250 | L6300, L6310, L6320, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6300 | L6350, L6360, L6370, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6310 | L6350, L6360, L6370, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6320 | L6350, L6360, L6370, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6350 | L6400, L6450, L6500, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6360 | L6400, L6450, L6500, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6370 | L6400, L6450, L6500, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6400 | L6550, L6570, L6580, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6450 | L6550, L6570, L6580, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6500 | L6550, L6570, L6580, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6550 | L6582, L6584, L6586, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6570 | L6582, L6584, L6586, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6580 | L6582, L6584, L6586, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6582 | L6588, L6590, L6600, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6584 | L6588, L6590, L6600, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6586 | L6588, L6590, L6600, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6588 | L6605, L6610, L6611, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6590 | L6605, L6610, L6611, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6600 | L6605, L6610, L6611, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6605 | L6615, L6616, L6620, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6610 | L6615, L6616, L6620, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6611 | L6615, L6616, L6620, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6615 | L6621, L6623, L6624, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6616 | L6621, L6623, L6624, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6620 | L6621, L6623, L6624, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6621 | L6625, L6628, L6629, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6623 | L6625, L6628, L6629, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6624 | L6625, L6628, L6629, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6625 | L6630, L6632, L6635, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6628 | L6630, L6632, L6635, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6629 | L6630, L6632, L6635, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6630 | L6637, L6638, L6640, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6632 | L6637, L6638, L6640, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6635 | L6637, L6638, L6640, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6637 | L6641, L6642, L6645, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6638 | L6641, L6642, L6645, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6640 | L6641, L6642, L6645, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6641 | L6646, L6647, L6648, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6642 | L6646, L6647, L6648, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6645 | L6646, L6647, L6648, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6646 | L6650, L6655, L6660, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6647 | L6650, L6655, L6660, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6648 | L6650, L6655, L6660, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6650 | L6665, L6670, L6672, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6655 | L6665, L6670, L6672, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6660 | L6665, L6670, L6672, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6665 | L6675, L6676, L6677, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6670 | L6675, L6676, L6677, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6672 | L6675, L6676, L6677, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6675 | L6680, L6682, L6684, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6676 | L6680, L6682, L6684, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6677 | L6680, L6682, L6684, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6680 | L6686, L6687, L6688, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6682 | L6686, L6687, L6688, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6684 | L6686, L6687, L6688, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6686 | L6689, L6690, L6691, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6687 | L6689, L6690, L6691, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6688 | L6689, L6690, L6691, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6689 | L6692, L6693, L6694, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6690 | L6692, L6693, L6694, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6691 | L6692, L6693, L6694, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6692 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6693 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6694 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6695 | L6698, L6700, L6703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6696 | L6698, L6700, L6703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6697 | L6698, L6700, L6703, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6698 | L6704, L6706, L6707, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6700 | L6704, L6706, L6707, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6703 | L6704, L6706, L6707, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6704 | L6708, L6709, L6711, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6706 | L6708, L6709, L6711, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6707 | L6708, L6709, L6711, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6708 | L6712, L6713, L6714, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6709 | L6712, L6713, L6714, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6711 | L6712, L6713, L6714, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6712 | L6715, L6721, L6722, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6713 | L6715, L6721, L6722, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6714 | L6715, L6721, L6722, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6715 | L6805, L6810, L6880, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6721 | L6805, L6810, L6880, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6722 | L6805, L6810, L6880, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6805 | L6881, L6882, L6883, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6810 | L6881, L6882, L6883, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6880 | L6881, L6882, L6883, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6881 | L6884, L6885, L6895, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6882 | L6884, L6885, L6895, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6883 | L6884, L6885, L6895, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6884 | L6900, L6905, L6910, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6885 | L6900, L6905, L6910, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6895 | L6900, L6905, L6910, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6900 | L6915, L6920, L6925, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6905 | L6915, L6920, L6925, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6910 | L6915, L6920, L6925, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6915 | L6930, L6935, L6940, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6920 | L6930, L6935, L6940, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6925 | L6930, L6935, L6940, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6930 | L6945, L6950, L6955, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6935 | L6945, L6950, L6955, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6940 | L6945, L6950, L6955, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6945 | L6960, L6965, L6970, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6950 | L6960, L6965, L6970, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6955 | L6960, L6965, L6970, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6960 | L6975, L7007, L7008, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6965 | L6975, L7007, L7008, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6970 | L6975, L7007, L7008, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L6975 | L7009, L7040, L7045, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7007 | L7009, L7040, L7045, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7008 | L7009, L7040, L7045, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7009 | L7170, L7180, L7181, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7040 | L7170, L7180, L7181, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7045 | L7170, L7180, L7181, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7170 | L7259, L7400, L7401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7180 | L7259, L7400, L7401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7181 | L7259, L7400, L7401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7259 | L7402, L7403, L7404, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7400 | L7402, L7403, L7404, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7401 | L7402, L7403, L7404, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7402 | L7405, L7406, L7499, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7403 | L7405, L7406, L7499, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7404 | L7405, L7406, L7499, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7405 | L7510, L7520, L8035, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7406 | L7510, L7520, L8035, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7499 | L7510, L7520, L8035, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7510 | L8499, L8720, L8721 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L7520 | L8499, L8720, L8721 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8035 | L8499, L8720, L8721 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8499 | Radiation therapy 32701, 61796, 61798, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8600 | cancer) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8641 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8679 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8682 | registered, please register here | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8683 | Noninvasive home ventilators E0466, E0468 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8698 | 02WA3QZ | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8701 | Pain infusion pump 62324, 62325, 62326, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8702 | Pain infusion pump 62324, 62325, 62326, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8720 | Radiation therapy 32701, 61796, 61798, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| L8721 | Radiation therapy 32701, 61796, 61798, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q2041 | Q2042, Q2053, Q2054, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q2042 | Q2055, Q2056, Q2057, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q2053 | Q2055, Q2056, Q2057, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q2054 | Q2055, Q2056, Q2057, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q2055 | Q2058, XW0338A, XW033C7 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q2056 | Q2058, XW0338A, XW033C7 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q2057 | Q2058, XW0338A, XW033C7 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q2058 | XW0338A, XW033C7 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4101 | Q4102, Q4103, Q4104, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4102 | Q4105, Q4107, Q4108, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4103 | Q4105, Q4107, Q4108, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4104 | Q4105, Q4107, Q4108, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4105 | Q4110, Q4111, Q4112, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4107 | Q4110, Q4111, Q4112, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4108 | Q4110, Q4111, Q4112, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4110 | Q4113, Q4114, Q4115, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4111 | Q4113, Q4114, Q4115, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4112 | Q4113, Q4114, Q4115, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4113 | Q4116*, Q4117, Q4118, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4114 | Q4116*, Q4117, Q4118, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4115 | Q4116*, Q4117, Q4118, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4116 | * | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4117 | * | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4118 | * | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4121 | * | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4122 | * | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4123 | * | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4124 | Q4127, Q4128*, Q4130, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4125 | Q4127, Q4128*, Q4130, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4126 | Q4127, Q4128*, Q4130, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4127 | * | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4128 | * | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4130 | * | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4132 | Q4135, Q4136, Q4137, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4133 | Q4135, Q4136, Q4137, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4134 | Q4135, Q4136, Q4137, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4135 | Q4138, Q4139, Q4140, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4136 | Q4138, Q4139, Q4140, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4137 | Q4138, Q4139, Q4140, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4138 | Q4141, Q4142, Q4143, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4139 | Q4141, Q4142, Q4143, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4140 | Q4141, Q4142, Q4143, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4141 | Q4145, Q4146, Q4147, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4142 | Q4145, Q4146, Q4147, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4143 | Q4145, Q4146, Q4147, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4145 | Q4148, Q4149, Q4150, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4146 | Q4148, Q4149, Q4150, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4147 | Q4148, Q4149, Q4150, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4148 | Q4151, Q4152, Q4153, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4149 | Q4151, Q4152, Q4153, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4150 | Q4151, Q4152, Q4153, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4151 | Q4154, Q4155, Q4156, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4152 | Q4154, Q4155, Q4156, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4153 | Q4154, Q4155, Q4156, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4154 | Q4157, Q4158, Q4159, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4155 | Q4157, Q4158, Q4159, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4156 | Q4157, Q4158, Q4159, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4157 | Q4160, Q4161, Q4162, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4158 | Q4160, Q4161, Q4162, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4159 | Q4160, Q4161, Q4162, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4160 | Q4163, Q4164, Q4165, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4161 | Q4163, Q4164, Q4165, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4162 | Q4163, Q4164, Q4165, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4163 | Q4166, Q4167, Q4168, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4164 | Q4166, Q4167, Q4168, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4165 | Q4166, Q4167, Q4168, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4166 | Q4169, Q4170, Q4171, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4167 | Q4169, Q4170, Q4171, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4168 | Q4169, Q4170, Q4171, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4169 | Q4173, Q4174, Q4175, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4170 | Q4173, Q4174, Q4175, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4171 | Q4173, Q4174, Q4175, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4173 | Q4176, Q4177, Q4178, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4174 | Q4176, Q4177, Q4178, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4175 | Q4176, Q4177, Q4178, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4176 | Q4179, Q4180, Q4181, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4177 | Q4179, Q4180, Q4181, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4178 | Q4179, Q4180, Q4181, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4179 | Q4182, Q4183, Q4184, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4180 | Q4182, Q4183, Q4184, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4181 | Q4182, Q4183, Q4184, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4182 | Q4185, Q4186, Q4187, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4183 | Q4185, Q4186, Q4187, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4184 | Q4185, Q4186, Q4187, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4185 | Q4188, Q4189, Q4190, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4186 | Q4188, Q4189, Q4190, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4187 | Q4188, Q4189, Q4190, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4188 | Q4191, Q4192, Q4193, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4189 | Q4191, Q4192, Q4193, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4190 | Q4191, Q4192, Q4193, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4191 | Q4194, Q4195, Q4196, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4192 | Q4194, Q4195, Q4196, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4193 | Q4194, Q4195, Q4196, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4194 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4195 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4196 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4197 | Q4200, Q4201, Q4202, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4198 | Q4200, Q4201, Q4202, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4199 | Q4200, Q4201, Q4202, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4200 | Q4203, Q4204, Q4205, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4201 | Q4203, Q4204, Q4205, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4202 | Q4203, Q4204, Q4205, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4203 | Q4206, Q4208, Q4209, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4204 | Q4206, Q4208, Q4209, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4205 | Q4206, Q4208, Q4209, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4206 | Q4211, Q4212, Q4213, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4208 | Q4211, Q4212, Q4213, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4209 | Q4211, Q4212, Q4213, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4211 | Q4214, Q4215, Q4216, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4212 | Q4214, Q4215, Q4216, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4213 | Q4214, Q4215, Q4216, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4214 | Q4217, Q4218, Q4219, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4215 | Q4217, Q4218, Q4219, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4216 | Q4217, Q4218, Q4219, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4217 | Q4220, Q4221, Q4222, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4218 | Q4220, Q4221, Q4222, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4219 | Q4220, Q4221, Q4222, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4220 | Q4224, Q4225, Q4226, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4221 | Q4224, Q4225, Q4226, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4222 | Q4224, Q4225, Q4226, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4224 | Q4227, Q4229, Q4230, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4225 | Q4227, Q4229, Q4230, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4226 | Q4227, Q4229, Q4230, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4227 | Q4232, Q4233, Q4234, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4229 | Q4232, Q4233, Q4234, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4230 | Q4232, Q4233, Q4234, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4232 | Q4235, Q4237, Q4236, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4233 | Q4235, Q4237, Q4236, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4234 | Q4235, Q4237, Q4236, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4235 | Q4238, Q4239, Q4240, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4236 | Q4238, Q4239, Q4240, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4237 | Q4238, Q4239, Q4240, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4238 | Q4241, Q4242, Q4245, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4239 | Q4241, Q4242, Q4245, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4240 | Q4241, Q4242, Q4245, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4241 | Q4246, Q4247, Q4248, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4242 | Q4246, Q4247, Q4248, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4245 | Q4246, Q4247, Q4248, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4246 | Q4249, Q4250, Q4251, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4247 | Q4249, Q4250, Q4251, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4248 | Q4249, Q4250, Q4251, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4249 | Q4252, Q4253, Q4254, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4250 | Q4252, Q4253, Q4254, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4251 | Q4252, Q4253, Q4254, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4252 | Q4255, Q4256, Q4257, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4253 | Q4255, Q4256, Q4257, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4254 | Q4255, Q4256, Q4257, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4255 | Q4258, Q4259, Q4260, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4256 | Q4258, Q4259, Q4260, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4257 | Q4258, Q4259, Q4260, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4258 | Q4261, Q4262, Q4263, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4259 | Q4261, Q4262, Q4263, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4260 | Q4261, Q4262, Q4263, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4261 | Q4264, Q4265, Q4266, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4262 | Q4264, Q4265, Q4266, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4263 | Q4264, Q4265, Q4266, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4264 | Q4267, Q4268, Q4269, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4265 | Q4267, Q4268, Q4269, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4266 | Q4267, Q4268, Q4269, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4267 | Q4270, Q4271, Q4272, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4268 | Q4270, Q4271, Q4272, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4269 | Q4270, Q4271, Q4272, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4270 | Q4273, Q4274, Q4275, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4271 | Q4273, Q4274, Q4275, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4272 | Q4273, Q4274, Q4275, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4273 | Q4276, Q4278, Q4279, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4274 | Q4276, Q4278, Q4279, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4275 | Q4276, Q4278, Q4279, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4276 | Q4280, Q4281, Q4282, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4278 | Q4280, Q4281, Q4282, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4279 | Q4280, Q4281, Q4282, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4280 | Q4283, Q4284, Q4285, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4281 | Q4283, Q4284, Q4285, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4282 | Q4283, Q4284, Q4285, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4283 | Q4286, Q4287, Q4288, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4284 | Q4286, Q4287, Q4288, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4285 | Q4286, Q4287, Q4288, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4286 | Q4289, Q4290, Q4291, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4287 | Q4289, Q4290, Q4291, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4288 | Q4289, Q4290, Q4291, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4289 | Q4292, Q4293, Q4294, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4290 | Q4292, Q4293, Q4294, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4291 | Q4292, Q4293, Q4294, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4292 | Q4295, Q4296, Q4297, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4293 | Q4295, Q4296, Q4297, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4294 | Q4295, Q4296, Q4297, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4295 | Q4298, Q4299, Q4300, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4296 | Q4298, Q4299, Q4300, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4297 | Q4298, Q4299, Q4300, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4298 | Q4301, Q4302, Q4303, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4299 | Q4301, Q4302, Q4303, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4300 | Q4301, Q4302, Q4303, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4301 | Q4304, Q4305, Q4306, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4302 | Q4304, Q4305, Q4306, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4303 | Q4304, Q4305, Q4306, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4304 | Q4307, Q4308, Q4309, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4305 | Q4307, Q4308, Q4309, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4306 | Q4307, Q4308, Q4309, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4307 | Q4310, Q4311, Q4312, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4308 | Q4310, Q4311, Q4312, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4309 | Q4310, Q4311, Q4312, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4310 | Q4313, Q4314, Q4315, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4311 | Q4313, Q4314, Q4315, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4312 | Q4313, Q4314, Q4315, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4313 | Q4316, Q4317, Q4318, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4314 | Q4316, Q4317, Q4318, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4315 | Q4316, Q4317, Q4318, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4316 | Q4319, Q4320, Q4321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4317 | Q4319, Q4320, Q4321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4318 | Q4319, Q4320, Q4321, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4319 | Q4322, Q4323, Q4324, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4320 | Q4322, Q4323, Q4324, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4321 | Q4322, Q4323, Q4324, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4322 | Q4325, Q4326, Q4327, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4323 | Q4325, Q4326, Q4327, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4324 | Q4325, Q4326, Q4327, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4325 | Q4328, Q4329, Q4330, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4326 | Q4328, Q4329, Q4330, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4327 | Q4328, Q4329, Q4330, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4328 | Q4331, Q4332, Q4333, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4329 | Q4331, Q4332, Q4333, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4330 | Q4331, Q4332, Q4333, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4331 | Q4334, Q4335, Q4336, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4332 | Q4334, Q4335, Q4336, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4333 | Q4334, Q4335, Q4336, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4334 | Q4337, Q4338, Q4339, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4335 | Q4337, Q4338, Q4339, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4336 | Q4337, Q4338, Q4339, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4337 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4338 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4339 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4340 | Q4343, Q4344, Q4345, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4341 | Q4343, Q4344, Q4345, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4342 | Q4343, Q4344, Q4345, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4343 | Q4346, Q4347, Q4348, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4344 | Q4346, Q4347, Q4348, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4345 | Q4346, Q4347, Q4348, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4346 | Q4349, Q4350, Q4351, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4347 | Q4349, Q4350, Q4351, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4348 | Q4349, Q4350, Q4351, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4349 | Q4352, Q4353, Q4354, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4350 | Q4352, Q4353, Q4354, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4351 | Q4352, Q4353, Q4354, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4352 | Q4355, Q4356, Q4357, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4353 | Q4355, Q4356, Q4357, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4354 | Q4355, Q4356, Q4357, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4355 | Q4358, Q4359, Q4360, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4356 | Q4358, Q4359, Q4360, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4357 | Q4358, Q4359, Q4360, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4358 | Q4361, Q4362, Q4363, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4359 | Q4361, Q4362, Q4363, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4360 | Q4361, Q4362, Q4363, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4361 | Q4364, Q4365, Q4366, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4362 | Q4364, Q4365, Q4366, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4363 | Q4364, Q4365, Q4366, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4364 | Q4367, Q4368, Q4369, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4365 | Q4367, Q4368, Q4369, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4366 | Q4367, Q4368, Q4369, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4367 | Q4370, Q4371, Q4372, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4368 | Q4370, Q4371, Q4372, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4369 | Q4370, Q4371, Q4372, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4370 | Q4373, Q4375, Q4376, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4371 | Q4373, Q4375, Q4376, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4372 | Q4373, Q4375, Q4376, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4373 | Q4377, Q4378, Q4379, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4375 | Q4377, Q4378, Q4379, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4376 | Q4377, Q4378, Q4379, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4377 | Q4380, Q4382, Q4383, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4378 | Q4380, Q4382, Q4383, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4379 | Q4380, Q4382, Q4383, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4380 | Q4384, Q4385, Q4386, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4382 | Q4384, Q4385, Q4386, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4383 | Q4384, Q4385, Q4386, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4384 | Q4387, Q4388, Q4389, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4385 | Q4387, Q4388, Q4389, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4386 | Q4387, Q4388, Q4389, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4387 | Q4390, Q4391, Q4392, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4388 | Q4390, Q4391, Q4392, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4389 | Q4390, Q4391, Q4392, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4390 | Q4393, Q4394, Q4395, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4391 | Q4393, Q4394, Q4395, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4392 | Q4393, Q4394, Q4395, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4393 | Q4396, Q4397, Q4398, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4394 | Q4396, Q4397, Q4398, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4395 | Q4396, Q4397, Q4398, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4396 | Q4399, Q4400, Q4401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4397 | Q4399, Q4400, Q4401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4398 | Q4399, Q4400, Q4401, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4399 | Q4402, Q4403, Q4404, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4400 | Q4402, Q4403, Q4404, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4401 | Q4402, Q4403, Q4404, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4402 | Q4405, Q4406, Q4407, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4403 | Q4405, Q4406, Q4407, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4404 | Q4405, Q4406, Q4407, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4405 | Q4408, Q4409, Q4410, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4406 | Q4408, Q4409, Q4410, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4407 | Q4408, Q4409, Q4410, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4408 | Q4411, Q4412, Q4413, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4409 | Q4411, Q4412, Q4413, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4410 | Q4411, Q4412, Q4413, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4411 | Q4414, Q4415, Q4416, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4412 | Q4414, Q4415, Q4416, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4413 | Q4414, Q4415, Q4416, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4414 | Q4417, Q4418, Q4419, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4415 | Q4417, Q4418, Q4419, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4416 | Q4417, Q4418, Q4419, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4417 | Q4420, Q4421, Q4422, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4418 | Q4420, Q4421, Q4422, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4419 | Q4420, Q4421, Q4422, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4420 | Q4423, Q4424, Q4425, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4421 | Q4423, Q4424, Q4425, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4422 | Q4423, Q4424, Q4425, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4423 | Q4426, Q4427, Q4428, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4424 | Q4426, Q4427, Q4428, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4425 | Q4426, Q4427, Q4428, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4426 | Q4429, Q4431, Q4432, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4427 | Q4429, Q4431, Q4432, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4428 | Q4429, Q4431, Q4432, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4429 | Q4433, Q4435, Q4436, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4431 | Q4433, Q4435, Q4436, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4432 | Q4433, Q4435, Q4436, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4433 | Q4437, Q4438, Q4439, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4435 | Q4437, Q4438, Q4439, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4436 | Q4437, Q4438, Q4439, | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4437 | Q4440 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4438 | Q4440 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4439 | Q4440 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| Q4440 | Category Subcategory/notes Codes and comments | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| S9445 | Crisis services | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| S9480 | Intensive outpatient (IOP) | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |
| T1000 | Hyperbaric therapy 99183, G0277 | 2026-01-01 | 2026-05-13 | 97% | [PDF] Humana Dual Highly Integrated Michigan Prior Authorization and ... |