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AZ-12-003A

Indicates that Published Rate is Paid for Up to 5 Visits Per Recipient in AHCCCS-registered facilities that provide covered services to Medicaid in an Indian Health Service or tribal 638 Facility.
State
Approval Date
Effective Date
File 1 - Approval Document Media
File 3 - Attachment Media
File 4 - Form CMS-179 Media