| Assigned Number |
Title |
Version Date | Publication Type | Other Location | Language |
|---|---|---|---|---|---|
| F-11014 | Prior Authorization / Dental Attachment 2 (PA/DA2) Oral Surgery, Orthodontic, and Fixed Prosthetic Services | February 17, 2020 |
Word
|
None | English |
| F-11014 | Prior Authorization / Dental Attachment 2 (PA/DA2) Oral Surgery, Orthodontic, and Fixed Prosthetic Services | February 17, 2020 |
PDF
|
None | English |
Last Revised: February 17, 2020
