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You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: K90.4; Item: 100619071; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0737; Item: 100821333; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0717; Item: 100034654; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z71.118; Item: 100915961; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0736; Item: 100035155; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z74.21; Item: 101867931; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0715; Item: 100628663; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0710; Item: 102034632; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0700; Item: 100036300; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0732; Item: 101049049; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z0736; Item: 100438878; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E72.22; Item: 102853119; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E73.9; Item: 102079638; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0734; Item: 101078237; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: K90.4; Item: 101282204; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z0731; Item: 100429007; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0737; Item: 100036342; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z91.011; Item: 101194078; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z0730; Item: 100036748; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0734; Item: 101689881; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0733; Item: 100037880; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0737; Item: 100684498; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.311; Item: 101161939; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: K90.9; Item: 100320740; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0737; Item: 101086253; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: K90.4; Item: 100613833; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: D81.810; Item: 101309171; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E72.3; Item: 102242617; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E72.22; Item: 101161946; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.19; Item: 100871429; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0715; Item: 102082677; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z0714; Item: 100325478; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0737; Item: 100665069; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0718; Item: 100034179; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.121; Item: 100037881; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: K90.8; Item: 100613867; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E88.89; Item: 100892026; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0735; Item: 100037417; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.311; Item: 101808711; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0718; Item: 100655928; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E03.1; Item: 100907718; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0717; Item: 101231561; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E74.21; Item: 100862733; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0733; Item: 101943737; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E03.1; Item: 100429752; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0714; Item: 100724284; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0716; Item: 103134992; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0710; Item: 100979692; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z90.9; Item: 100034494; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z0700; Item: 100821341; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0716; Item: 101161954; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.118; Item: 101141267; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0738; Item: 100438624; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.118; Item: 101094191; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.311; Item: 100429891; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z0738; Item: 100684518; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.310; Item: 100908294; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: D81.810; Item: 100915971; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E03.1; Item: 100979720; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0738; Item: 100628524; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0733; Item: 100438544; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0714; Item: 102079670; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0726; Item: 102743729; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0717; Item: 100035059; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z71.121; Item: 100620944; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0718; Item: 100881335; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0710; Item: 100035884; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E72.23; Item: 101808738; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.ÿ0; Item: 100034304; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P07.1; Item: 100035104; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0717; Item: 101068806; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0715; Item: 103016777; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P07.1; Item: 100665051; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z0739; Item: 100034515; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E72.22; Item: 100038146; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0714; Item: 100438595; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z71.310; Item: 103128496; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.110; Item: 100034822; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E74.21; Item: 100429091; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z91.011; Item: 101275505; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: D81.810; Item: 101401161; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z03.1; Item: 102353659; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z81.810; Item: 100035091; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.120; Item: 100429859; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E72.3; Item: 100625391; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E25.0; Item: 100036301; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0737; Item: 100997102; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.ÿ0; Item: 101765661; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.ÿ0; Item: 101075458; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E72.22; Item: 100037880; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0715; Item: 101443169; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0716; Item: 100036271; TotalCost: 4; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: Z03.1; Item: 100613841; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0736; Item: 102242625; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.311; Item: 100655910; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.19; Item: 101929134; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P0714; Item: 101679833; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: P07.1; Item: 101867957; TotalCost: 121; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.19; Item: 100732293; TotalCost: 1001; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
❌ Disapproved
You are an authorization engine. Rule: Baby Milk Diagnosis #108, ICD-10 must be in ['E03.1', 'E25.0', 'E70.0', 'E71.ÿ0', 'E71.121', 'E71.120', 'E71.19', 'D81.810', 'E72.3', 'E71.110', 'E71.118', 'E71.19', 'E72.22', 'E72.23', 'E71.311', 'E71.310', 'E74.21', 'E88.89', 'E73.9', 'Z91.011', 'K90.9', 'K90.4', 'K90.8', 'P07.1...
ICD-10: E71.19; Item: 100438165; TotalCost: 888; Patient Age: 0; Gender: Male; Prescription Date Difference: 0; Payer: any; Policy ID: any; Policy Name: other
✅ APPROVED