Dental Electronic Funds Transfer (EFT) …
Category Code – PRIN GR-68960 (5-15) Page 2 of 4 Dental Electronic Funds Transfer (EFT) Authorization Agreement Please fax only one TIN per form.
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Current Dental Terminology © American Dental …
www.aetnadental.comNo Code D4240 gingival flap procedure, including root planing - four or more contiguous teeth or bounded teeth spaces per quadrant No Code
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