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Get CA Delta Dental GP07 2006-2024

Vider Name Patient ID Number License Number National Provider Identifier INFORMATION REQUIRED: NUMERICAL CHARTING OF POCKET DEPTHS, BONE LOSS, MOBILITIES, TEETH TO BE EXTRACTED AND MISSING TEETH. CHART AT LEAST TWO NUMBERS FOR FACIAL AND TWO NUMBERS FOR LINGUAL SURFACES OF EACH TOOTH. EXAMPLES Teeth to be extracted (#31) 32 31 30 Missing Teeth ( #19) 19 18 17 MOBILITY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 None = 0 Slight = 1 Moderate = 2 32 31 3.

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