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Va Form Dental

Va Form Dental

Use a va form 10 2570d template to make your document workflow more streamlined.

To make a determination of the extent and type of treatment to be authorized. The allowable fees for radiographs and examination have been indicated in Item 14 on page 3 of this form. The fee for radiographs is based on a full mouth series. This is a basic requirement when no diagnostically usable radiograph record exists relating to a complete dentition. In a circumstance where depleted dentition or edentulous status exists, the requirement for radiographs should be modified by the examining...
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