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WV MEDICAID PRIOR AUTHORIZATION FORM FAX 18446338431 DENTAL/ORTHODONTICTodays Date REGISTRATION ON C3 IS REQUIRED TO SUBMIT PRIOR AUTHORIZATION REQUESTS WHETHER BY FAX OR ELECTRONICALLY. DETERMINATIONS

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What is updated 063016 dentaldocx?

updated 063016 dentaldocx is a document that contains updated information related to dental procedures.

Who is required to file updated 063016 dentaldocx?

Dental professionals or clinics who provide dental services are required to file updated 063016 dentaldocx.

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Updated 063016 dentaldocx can be filled out by providing accurate information about the dental procedures performed.

What is the purpose of updated 063016 dentaldocx?

The purpose of updated 063016 dentaldocx is to keep a record of dental procedures and ensure accurate reporting.

What information must be reported on updated 063016 dentaldocx?

Information such as the type of dental procedure, date performed, and patient's information must be reported on updated 063016 dentaldocx.

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