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New York State Medicaid Program Dental Policy - eMedNY
A referral is the direction of a member to another provider for advice or Claim Form A can be obtained from eMedNY by calling (800) 343-9000.
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Referral pattern to a university-based oral and maxillofacial
by FM Jadu 2019 Cited by 2 Results: A total of 660 referral forms were analyzed. Oral and maxillofacial surgeons were the discipline to most commonly request CBCT examinations.
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Cone Beam CT Referral Form
Cone Beam CT Referral Form. Ordered By. Doctor Name: Address: State/Province: Zip/Postal Code: Phone: Fax: Email: Practice Name: Patient Information.
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