Dental Policies
Navigate directly to a letter:
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E
- Establishment and Adoption of Utilization Review Criteria and Clinical Guidelines.pdf
- Exhibit A-Short Procedure Units (SPU).pdf
- Exhibit AA-Frenectomy.pdf
- Exhibit B-Periodontal Clinical Criteria.pdf
- Exhibit BB-Direct Restoration.pdf
- Exhibit C-Dental Extraction.pdf
- Exhibit D-Crown.pdf
- Exhibit E-Fixed Prosthodontics.pdf
- Exhibit F-Endodontics.pdf
- Exhibit G-Radiographics.pdf
- Exhibit H-Bone Tissue Excision.pdf
- Exhibit I-Non-Restorable Tooth.pdf
- Exhibit L-Removable Prosthetics.pdf
- Exhibit M-Administration of Nitrous Oxide.pdf
- Exhibit N-Orthodontics.pdf
- Exhibit O-General Anesthesia and IV Sedation.pdf
- Exhibit P3-Mail Order Orthodontics.pdf
- Exhibit S-Onlay.pdf
- Exhibit T-Veneer.pdf
- Exhibit X-Implant.pdf