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new york state medicaid program dental procedure codes
Apr 1, 2010 The initial dental examination of a new patient shall consist of a comprehensive clinical examination of the oral cavity and teeth. It shall
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DD 2480, DODMERB Report of Dental Examination
HISTORY OF ORAL DISEASE, TUMOR OR ANY OTHER ABNORMALITY OF THE ORAL CAVITY (X Yes or No for each question. If additional space is needed, use REMARKS section.).
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REPORT OF DENTAL EXAMINATION OF APPLICANTS TO
Present this form to your examining dentist for completion. Failure by you or your examiner to comply completely will delay medical clearance, which is
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