*2026-04-13 Disclosure Claim Data Report

Claim Number:42647461 Worker Name:MARK HOLAND Date Created:13-4-2026 1:05 PM

View Decision: Claim 42647461

Plan Item Name: Acupuncture - Report Fee Provisions: Current Provision
Daie Entered: 2026/03/20 Decision Effective Date: 2026/03/20
Decision Type: Entitlement Modification Policy:
Decision Basis: New Matter Decision made by: SYSTEM
Decision Outcome: Accepted Approved Date: 2026/03/20
Status: Completed Replacing:
Decision Reason: Claim Not Eligible Core: Yes
75 Day Limit: 2026/06/03 90 Day Limit: 2026/06/18

Decision Rationale

Supporting Documents

Document Type Document Date Description

Page 61