Advanced Imaging Ordering Program Procedure Request Form
Advanced Imaging Ordering Program Procedure Request Form. NYS Medicaid FFS is providing this form for use with the Advanced Imaging Ordering Program. It can be used as a tool when calling HealthHelp or it can be faxed to HealthHelp at (888) 209-9634. for consultations on certain CT, MR, Cardiac Nuclear Medicine, or PET scans.
Download Advanced Imaging Ordering Program Procedure Request Form
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