CREDENTIALING INFORMATION FORM
Procedure Decision Comments ... (not requested (granted ( denied D&C Therapeutic ( requested (not requested (granted ( denied Endometrial Ablation-Electrosurgical ( requested (not requested (granted ( denied Hymenotomy ( requested (not requested (granted ( denied Hysteroscopy ( requested (not requested (granted ( denied Cervical Conzation/ LEEP ... ................
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