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