Application Detail

Description of Medical Service

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Description of Medical Condition

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Reason for Application

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Medical Service Type

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Previous Application Number

Not Applicable

Associated Documentation

Application Form

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PICO Confirmation

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Assessment Report

Assessment Report (PDF 2762 KB)

Public Summary Document

One Page Summary (PDF 24 KB)
One Page Summary (Word 47 KB)

Predicted versus Actual

Public Summary Document - April 2017 (PDF 446 KB)
Public Summary Document - April 2017 (Word 184 KB)

Meetings for this Application

PASC

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ESC

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MSAC

15 November 2006
6-7 April 2017