On this page is a compilation of the obsolete pages as they correspond to the revision date. Click on a date to see the manual chapter page(s) prior to the revision.

Page replaced from 05/01/2024 revision – Title Page

Pages replaced from 01/04/2024 revision – Section 1.1 – Provider Requirements

Pages replaced from 01/04/2024 revision – Section 1.4 – General Claims Filing

Pages replaced from 10/27/2023 revision – Table of Contents

Pages replaced from 10/27/2023 revision – Section 1.1 – Provider Requirements

Pages replaced from 10/27/2023 revision – Section 1.3 – Program Integrity

Pages replaced from 10/27/2023 revision – Section 1.4 – General Claims Filing

Pages replaced from 10/27/2023 revision – Section 1.5 – Benefits for Children and Youth

Pages replaced from 10/03/2023 revision – Section 1.4 – General Claims Filing

Pages replaced from 08/28/2023 revision – Table of Contents

Pages replaced from 08/28/2023 revision – Section 1.0 – Overview

Pages replaced from 08/28/2023 revision – Section 1.1 – Provider Requirements

Pages replaced from 08/28/2023 revision – Section 1.2 – Beneficiary Eligibility

Pages replaced from 08/28/2023 revision – Section 1.3 – Program Integrity

Pages replaced from 08/28/2023 revision – Section 1.4 – General Claims Filing

Pages replaced from 08/28/2023 revision – Section 1.5 – Benefits for Children and Youth

Pages replaced from 08/28/2023 revision – Appendix A – Definitions/Acronyms

Pages replaced from 08/28/2023 revision – Appendix B – Contact/Referral Information

Pages replaced from 08/28/2023 revision – Appendix C – Revision History Log

Pages replaced from 04/01/2021 revision – Chapter 1 Section 1.4- General Claims Filing

Pages replaced from 12/18/2018 revision – Section 1.2 – Recipient Eligibility

Pages replaced from 10/18/2017 revision – Chapter 1 Section 1.4- General Claims Filing

Page replaced from 08/15/2017 revision – Title Page

Pages replaced from 08/15/2017 revision – Section 1.4 General Claims Filing

Pages replaced from 04/22/2016 revision – Section 1.1 - Provider Requirements

Page replaced from 09/25/2015 revision – Title Page

Pages replaced from 10/23/2014 revision – Appendix B – Contact/Referral Information

Pages replaced from 06/30/2014 revision – Table of Contents - Issued 11/08/12

Pages replaced from 06/30/2014 revision – Chapter 1 Section 1.4- General Claims Filing - Issued 11/08/12

Pages replaced from 06/30/2014 revision – Appendix D - Issued 06/01/11

Pages replaced from 11/20/2013 revision – Section 1.2 – Recipient Eligibility - Issued 11/08/2012

Pages replaced from 11/20/2013 revision – Appendix B – Contact/Referral Information - Issued 07/01/2011

Pages replaced from 06/14/13 revision – Section 1.5 – Benefits for Children and Youth - Issued 04/01/2013

Pages replaced from 04/01/13 revision – Section 1.5 – Benefits for Children and Youth - Issued 07/01/2011

Pages replaced from 11/08/12 revision – Table of Contents – Issued 12/12/2011

Pages replaced from 11/08/12 revision – Section 1.1 - Provider Requirements – 06/01/2011

Pages replaced from 11/08/12 revision – Section 1.2 – Recipient Eligibility – 06/01/2011

Pages replaced from 11/08/12 revision – Section 1.4 – General Claims Filing – Issued 12/15/2011

Pages replaced from 12/15/11 revision – Section 1.4 – General Claims Filing – Issued 06/01/2011

Pages replaced from 12/15//11 revision – Table of Contents – Issued 07/01/2011

Pages replaced from 07/01/11 revision – Table of Contents – Issued 06/01/2011

Pages replaced from 07/01/11 revision – Appendix B – Issued 06/01/2011

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