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MEDICAL POLICY No. 91444R7 PANNICULECTOMY/ACROMIOPLASTY Effective Date: October 1, 2015Date Of Origin: August 22, 2001I. Review Dates: 8/01, 12/01, 4/02, 4/03, 12/03, 3/04, 3/05, 2/06, 2/07, 7/07,

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Review dates 801 1201 refer to the dates set for reviewing certain financial documents or information.

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