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Get Nv Fa-19 2019-2024

To 1 (855) 709-6847 For assistance please contact Nevada Medicaid Customer Service 1 (800) 525-2395 Screening Type Reason For Screening (select one) Date Service Level (select one) Initial Placement Standard Retro Eligibility Pediatric Specialty Care I ** Service Level Change Pediatric Specialty Care I I ** Time Limitation Ventilator Dependent * * If Ventilator Dependent, you must attach medical records indicating the date the recipient went on/off the ventilator. ** If Pediatric Sp.

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