D2420 Dental Code 0000014183 00000 n
D2392 Dental Code Cost - Idema I just did the fillings today and this is how much they charged me: For each 2 surface composite filling, code D2392, my insurance pays $106, and the dentist charged . Replace all teeth and acrylic on cast metal framework (mandibular). The cost estimates provided may be different from your actual costs for several reasons, including but not limited to, your unique dental circumstances and the decisions made by you and your dental professionals as to what services you will receive, deviations between the anticipated scope of services and the services actually provided, and the characteristics of your particular plan. Inhalation of Nitrous Oxide Online Handbook topic, Oral Devices/Appliances Online Handbook topic, Custom Preparation of Maxillofacial Prosthetics Online Handbook topic, Frenulectomy Procedures Online Handbook topic, Place of Service Codes for Professional Claims Database, Periodic oral evaluation established patient. Trusted by 2,000,000+ members Verified Get Codes *** 20% OFF 20% OFF KLIPSCH PROMEDIA SPEAKERS through AUGUST 31ST Receive an extra 20% OFF off your orders at Klipsch. Save time searching for promo codes that work by using bestcouponsaving.com. Impression and custom preparation; surgical obturator prosthesis. This includes documenting the medical necessity of services in the members medical record. This cost estimator is intended for use in the 50 states, Puerto Rico and other U.S. territories. Place of Service Codes for Dental Treatment. Revised 10/14/2020. Premier Access . Recementation of a bridge is 06930. What is thought to influence the overproduction and pruning of synapses in the brain quizlet? This CDTCodes.org is a high-quality CDT codes information hub that has no affiliation with any dental organization or with any federal or state department, agency, office, board, or commission. Allowable with PA for members 20 years of age or younger when criteria are met. ERUPTED TOOTH OR EXPOSED ROOT (ELEV. This does not include denying or adjusting claims for covered services according to the terms of a member's dental benefit plan. For more detailed information on your dental care costs, please consult your dentist or your Delta Dental. Procedure code D9223 is limited to two units of service per day for a total of three units of service per day when combined with procedure code D9222. Once per five years, per tooth (tooth numbers 1-32 and 51-82 only). You also have the option to opt-out of these cookies. Start : WebJan 03, 2022 0000009315 00000 n
The site tracks coupons codes from online stores and update throughout the day by its staff. $87.00. 0000111733 00000 n
Who is the best person to do root canals? Direct placement of a restorative material to protect tooth and/or tissue form. ALVEOLOPLASTY NOT IN CONJ. FROM EXTRACTS. These cookies track visitors across websites and collect information to provide customized ads. CDT Code for Dental Recement Bridge Back to main page D6930 is an appropriate code for bridge recementation. Incision and drainage of abscess intraoral soft tissue complicated (includes drainage of multiple fascial spaces), Incision and drainage of abscess extraoral soft tissue, Incision and drainage of abscess extraoral soft tissue complicated (includes drainage of multiple fascial spaces), Removal of foreign body from mucosa, skin, or subcutaneous alveolar tissue. Procedure code D4355 requires PA when performed on children through the age of 12. PPO Plan. DMMA Adult Dental Benefit: codes & Description. Reimbursement is allowable only for services that meet all program requirements. What country has the most dentists per capita? Allowable age less than 21.Includes exam, diagnostic tests and consult. D2391, D2392, D2393, D2394 Resin-based Composite Restoration-Posterior Tooth- Primary or Permanent D2391 1-Surface D2392 2-Surface D2393 3-Surface D2394 4-plus Surface Periodontics When submitting claims for periodontal procedures, it is strongly advised that the claim contain information regarding the type of disease process present. One per six-month period, per member, per provider. This procedure may be used to relieve pain, promote healing, and prevent further deterioration. D2392 -basedcomposite;two surfaces, posterior Age 21 00: Sametooth& surface covered once in 2 years Resin D2393 -basedcomposite; three . Limited to one unit per day with a one-unit maximum per lifetime, per tooth. D2392 Resin based composite - two surfaces, posterior $53 $41 Louisiana Dental Plan is a reduced fee Dental Preferred Provider Network (DPPN). Total of four units per DOS.Note: An image of the obstructed frenum is not required to be submitted with claims but must be available in the medical or dental record. Etiology and manifestation codes may not be used as a primary diagnosis. The difference is whether the tooth being treated is deciduous (ITR) or permanent tooth (ART). 0000022462 00000 n
The secure version (available only after you sign in) uses procedure costs or cost ranges as reflected in provider fee schedules and aggregated historical cost data. 1Retain records in member files regarding nature of emergency. CDT Code D2331 A white (resin) dental filling on two anterior surfaces (incisors and canine teeth), primary or permanent. 0000053126 00000 n
Without insurance, it may cost $2,500 per gold crown and anywhere between $800 and $1,500 per crown in general. Combined maximum reimbursement limit per six months for repairs.Requires an area of oral cavity code (01=Maxillary or 02=Mandibular) in the appropriate element of the claim form. The PTDP may not be combined with any other insurance or discount plan; non-covered benefits are excepted. Palliative (emergency) treatment of dental pain minor procedure. Use this code for billingTMJ (temporomandibular joint)assistant surgeon.Procedure must be included in PA request for the surgery itself.Only allowable in hospital or ambulatory surgical center POS. The Dental Care Cost Estimator provides an estimate and does not guarantee the exact fees for dental procedures, what dental benefits your plan will cover, or your out-of-pocket costs. +MORE spring2018 Get Codes Expires Jan 28, 2023 Details Save 20% On UltraLEDS Get the best price with this UltraLEDS for January 2023. Get started here. It is used to document and report the use and cost of additional personal protective equipment (PPE). Is there a CPT code for an occlusal guard? Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Code billable only by dental hygienists. One per six-month period, per member, per provider, for members under the age of 21. Any restoration that does not fit a designated code description should be reported using D2999 with a narrative. a(.UshoW&GamUK6C\Vq_~k(0^9;L^ 0000010556 00000 n
0000003736 00000 n
Emergency only(tooth numbers 132, CH, MR, 5182, CSHS, and MSRS).1Operative report required on claim submission. All of those matters are things that you should decide, in consultation with your dental care professionals. 0
I Incisal the biting edge of the incisal and canine teeth. Our Dental Care Cost Estimator tool provides estimated cost ranges for common dental care needs. This includes documenting the medical necessity of services in the members medical record. What percentage of americans never go to the dentist? Operative report required on claim submission. . What is the dental insurance code for recement Crown? What percent of the population goes to the dentist? First and second primary molar only (tooth letters A, B, I, J, K, L, S, and T only). AllowablePOS (place of service)codes for oral surgery services are listed in the following table. Want to know before you set foot in the dentists office? Each quadrant must be indicated on a separate detail. Covered restorative services are identified by the allowable CDT procedure codes listed in the following table. This code is used for a procedure that recements or rebonds fixed partial denture. CDT codes, also known as Current Dental Terminology, are a reference manual codes published annually by the ADA (American Dental Association), and used to reference the code on dental procedures and nomenclature (CDT Code) by dentists and dental facilities as well as the dental insurance companies. It does not store any personal data. "Delta Dental" refers to the national network of 39 independent Delta Dental companies that provide dental insurance. BadgerCare Plus has identified allowable areas of oral cavity codes for dental services providers. .}\U\ TO HIGH CARIES RISK PATS. endstream
endobj
startxref
Can a dentist fix multiple cavities at once? CDT codes, also known as Current Dental Terminology, are a reference manual codes published annually by the ADA (American Dental Association), and used to reference the code on dental procedures and nomenclature (CDT Code) by dentists and dental facilities as well as the dental insurance companies. 1Following reimbursement of an apexification procedure (initial visit, interim visit, or final visit), ForwardHealth will not reimburse any of the following procedures for a lifetime on the same tooth: pulpal debridement of permanent tooth, partial pulpotomy for apexogenesis, or endodontic therapy of an anterior, premolar, or molar tooth. Refer to the appropriate dental service category (i.e., diagnostic, preventative, or periodontics) for coverage limitations. The federal government has designated the CDT Code as the national terminology that should be used to inform dental services of claims to third party payers. The costs provided in this tool are estimates only and are not a guarantee of payment or benefits. Occlusal guard hard appliance, partial arch, Unspecified adjunctive procedure, by report. It may be a covered dental benefit when reported with oral surgery procedures. D2392 RESIN-TWO SURFACES, POSTERIOR $71.50 $55.00 D2393 RESIN-THREE SURFACES, POSTERIOR $85.80 $66.00 . Applicable Codes . General information regarding your health care. . You can easily access coupons about "Free Now Dental Code D2392 Cost" by clicking on the most relevant deal below. Complete Dentures (Including Routine Post-Delivery Care), Partial Dentures (Including Routine Post-Delivery Care), Maxillary (upper) partial denture; resin base (including any conventional clasps, rests and teeth), Mandibular (lower) partial denture; resin base (including any conventional clasps, rests and teeth), Maxillary partial denture; cast metal framework with resin denture bases (including any conventional clasps, rests and teeth). How often do most adults go to the dentist? d2392: resin-based composite - 2 surfaces posterior: $186; d2393: resin-based composite - 3 surfaces posterior: $222; d2394: resin-based composite - 4 or more surfaces posterior: $256; d2510: inlay-metallic-1 surface: $593; d2520: inlay-metallic-2 surfaces: $656; d2530: inlay-metallic-3/more surfaces: $759; d2542: onlay-metallic-2 surfaces: $774; d2543: onlay-metallic-3 surfaces: $828; d2544 What is dental Code D2392? Discover incredible discounts with this offerGet This Code And Save 50%. 0000030956 00000 n
Being certified allows them to meet with patients, prepare the dental team, and educate patients about oral care. Refer to theDental Maximum Allowable Fee Schedulefor allowable CPT procedure codes.3Frequency limitation may be exceeded if a narrative on the claim demonstrates medical necessity for additional services. CDT Code D2392 A white (resin) dental filling on two posterior surfaces (premolars and molars), primary or permanent. Intraoral complete series of radiographic images, Intraoral periapical first radiographic image, Intraoral periapical each additional radiographic image, Extra-oral 2D projection radiographic image created using a stationary radiation source, and detector. These cookies ensure basic functionalities and security features of the website, anonymously. Providers should refer to thePlace of Service Codes for Professional Claims Databasefor the list of all acceptable POS codes. This take $670 Off at Very Exclusive makes your favorites affordable at Very Exclusive. most Commonly Performed Procedure Code Comparison Cigna Dental Care (DHMO)* Patient Charge Schedules 887393 09/15 Page 1 CDT 2016 Covered under Procedure Code1 Dental Description and Nomenclature Cigna Dental . Your email address will not be published. Clarification of the sedative filling . COMPOSITE RESTORATIONS: D2330, D2331, D2332, D2335, D2391, D2392, D2393, D2394 Coverage is limited to 1 of any of these procedures per 6 month(s). We will conform the updates youve sent for D2391 Dental Code or any other dental billing CDT codes and publish them upon confirmation. removal of fixed bilateral space maintainer maxillary, removal of fixed bilateral space maintainer mandibular, distal shoe space maintainer fixed, unilateral per quadrant. <]/Prev 142108>>
Shop and save now! Allowed once per six months.Must be in an office setting.Must be rendered by an oral surgeon, orthodontist, pediatric dentist or prosthodontist.Medical necessity as determined by defect and prognosis must be demonstrated.Refer to theCustom Preparation of Maxillofacial Prosthetics Online Handbook topicfor limitations and requirements. General information regarding your dental benefits, General information regarding cost estimates, More information regarding how cost estimates are calculated. 0000021206 00000 n
By clicking, you agree that you have read the informationbelow,are accessing this information for purposes of determining treatment cost estimates for dental care services you are considering receiving, and will not use the information in this tool for a commercial or anti-competitive purpose. Covered orthodontic services are identified by the allowable CDT procedure codes listed in the following table. Endodontic therapy is a routine dental procedure, but it is a complex procedure none the less. Reimbursement maximum is 15 minutes.Not billable to the member.Bill only D9239 and D9243 for intravenous sedation.Not payable with D9223, D9230, or D9248. What is the ADA code for Recement veneer? Once per DOS.3Operative report required on claim submission. Reimbursement is allowable only for services that meet all program requirements. What is the CDT code for dental recement bridge? Allowed only once per tooth.Primary teeth only (tooth letters AT and ASTS only).Not payable sameDOS (date of service)as D7250 for same tooth letter. 0000011667 00000 n
%%EOF
0000001894 00000 n
This cookie is set by GDPR Cookie Consent plugin. What happens during a deep teeth cleaning? If you file claims for dental benefits as an in-network or out-of-network provider or participate in electronic communications or transactions that fall within the scope of HIPAA, you will use CDT dental codes. DENTAL GENERAL FEE SCHEDULE 2022 1. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc. e`ea =AG/LGtQ0q(MyPADbso{U,,? wuX,zOW8:m;5*q* F!Q',3s`RRRh CDHfc0BeT#L S@3-Bc=FM@Zea 7iX;\%8>pwnv7`Am
H3q[20F Vg
Osseous, osteoperiosteal, or cartilage graft of the mandible or facial bones autogeneous or nonautogeneous, by report, Sinus augmentation with bone or bone substitutes, Frenulectomy (frenectomy or frenotomy) separate procedure. 0000080921 00000 n
Cost estimates are specific to geographic areas, as defined by the first three digits of a ZIP code (e.g., the geo ZIP for 12345 is 123). hb`````f`c`ed@ A f@ ?@HcN3osW6``h@d`a@,hT!M:\
jE*B7710bra,f&6-Y@!;Nm6e7#1g3F5 T yI
`(1Cd-k;(@ JS
Allowed once per year, per member, per provider. Upgraded partial denture. Procedure Code 0-20 Year Rate 21+ Year Rate Maximum Age Prior Authorization DENTAL GENERAL FEE SCHEDULE 2022 D2391 46.08 20 D2392 60.94 20 D2393 75.80 20 D2394 90.66 20 D2710 114.45 20 D2721 126.34 20 D2740 338.88 20 D2751 338.88 20 D2920 25.27 20 D2928 101.07 You are advised to ensure that when you select to use D2391 Dental Code in the dental procedure billing, you be sure to check if there is a different CDT codes, as alternative dental procedure code that fits better, to ensure your process is done currently and that you have selected the best CDT code matching the procedure you are billing for. BadgerCare Plus also recognizes supernumerary teeth that cannot be classified under A through T or 1 through 32. For primary teeth, an S will be placed after the applicable tooth letter (values AS through TS). Our Dental Care Cost Estimator provides estimated cost ranges for common dental care needs. One per day, up to two per six-month period, per member, per provider. For more detailed information on your actual dental care costs, please consult your dentist or your Delta Dental. 2Frequency limitation may be exceeded only with PA. This website shows estimates of certain dental care costs. trailer
Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features. Diagnosis codes indicated on 1500 Health Insurance Claim Forms and837P (837 Health Care Claim: Professional)transactions (and PA requests when applicable) must be from theICD (International Classification of Diseases)coding structure. You should check all promotions of interest at the store's website before making a purchase. 0
136 0 obj
<>stream
D2392 Resin Based Composite - Two Surfaces - Posterior D2393 Resin Based Composite - Three Surfaces - Posterior D2394 Resin Based Composite - Four Surfaces - Posterior D2750 * Crown - Porcelain Fused to High Noble Metal D2752 * Crown - Porcelain Fused to Noble Metal D2920 Recement Crown / Bridge D2950 Core Buildup - Including any Pins Providers are reminded that the POS code must accurately represent the location where the service was rendered. Dentists are not required to indicate a diagnosis code onADA (American Dental Association)2012 Claim Forms,837D (837 Health Care Claim: Dental)transactions, or onPA (prior authorization)requests withCDT (Current Dental Terminology)procedure codes. Gingivectomy or gingivoplasty four or more contiguous teeth or tooth bounded spaces per quadrant. D2542 Dental Code A regular review of your code can reduce the risk of fraud while ensuring that dental claims are submitted in compliance. 0000038088 00000 n
Operative report required on claim submission.Not to be used for periodontal abscessuse D9110. Combined maximum reimbursement limit per six months for repairs.Requires area of oral cavity code 02=Mandibular in the appropriate element of the claim form. D2392 Dental Code Cost - Idema According to a fee survey conducted in 2011 by the American Dental Association, the national mean fee for CDT code D2392 , resin-based composite, . 0000021989 00000 n
Limited to one unit per day with a two-unit maximum per lifetime, per tooth. The nomenclature defines D2940 as a protective . Not allowed for primary or wisdom teeth (tooth numbers 215, 1831, 5265, and 6881 only).Allowable for members ages 0-20.Covered fororthodontic reasons.Clinical notes and an operative report must be retained in the members medical or dental record. How to find promo codes that work? Indian Health Service Free-Standing Facility, Indian Health Service Provider-Based Facility, Intermediate Care Facility/Individuals with Intellectual Disabilities, Comprehensive Inpatient Rehabilitation Facility. Post and core in addition to crown, indirectly fabricated. Preventive care coverage varies by plan and by demographic considerations such as age. Covered removable prosthodontic services are identified by the allowableCDT (Current Dental Terminology)procedure codes listed in the following table. This procedure may be used to relieve pain, promote healing, or prevent further deterioration. ALVEOLOPLASTY NOT W/EXTRACTIONS PER QUADRANT. Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. One per three years, per member, per provider. What can a dentist prescribe for tooth pain? The Role of the Dentist Diagnose Oral Diseases. Prefabricated post and core in addition to crown, Additional procedures to construct new crown under existing partial denture framework, Unspecified restorative procedure, by report. This website uses cookies to improve your experience while you navigate through the website. 0000066046 00000 n
Such fillings are referred to as "tooth-colored" because of their unique ability to mirror the color, texture and luminescence of your own teeth. Removal of impacted tooth partially bony, Removal of impacted tooth completely bony, Removal of impacted tooth completely bony, with unusual surgical complications, Removal of residual tooth roots (cutting procedure). 3The same DOS limitation may not be exceeded in an emergency. 1Limitation may be exceeded if narrative on claim demonstrates medical necessity for replacing a properly completed filling, crown, or adding a restoration on any tooth surface. Covered endodontic services are identified by the allowable CDT procedure codes listed in the following table. 0000032208 00000 n
Allowable area of oral cavity codes: 10 (upper right), 20 (upper left), 30 (lower left), 40 (lower right).X-ray, treatment notes and treatment plan required. Show Related Procedures Compare Selected Search again Procedure Name Insurance Carrier Filter Results by Distance + Actual driving distances may vary Cost Data Source Procedure Fees. What are some examples of how providers can receive incentives? The following procedure codes are covered under BadgerCare Plus and Medicaid. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. Not allowed for removal of root fragments and bone spicules. CODE PERIODONTIC PROCEDURES USUAL FEE* YOUR COST YOU SAVE D4210 Gingivectomy or gingivoplasty - four or more contiguous teeth or tooth bounded spaces per quadrant $700 $285 $415 D4211 Gingivectomy or gingivoplasty - 1 to 3 contiguous teeth or tooth bounded spaces per quadrant $350 $140 $210 D4240 Gingival flap procedure, including root planing - 4 or more Patients who require a root canal can expect to pay between $750 and $1200 for the procedure itself. 0000014526 00000 n
D_0*[sQGfO=nnS:Cz8B?nzi~ PA not required for children (ages 0-20), when performed by an oral surgeon or pediatric dentist. BadgerCare Plus recognizes tooth letters A through T for primary teeth and tooth numbers 1 through 32 for permanent teeth. BRUSHiNG OF ORAL MUSC. As such, the dentist is also required to select the appropriate diagnostic code for patient records and claim filing. What can i do to help with covid-19 fatigue? D2392: Resin-based composite two surfaces, posterior: No: Primary teeth: Once per year, Tribal 638 Free-Standing Facility: 11: Office: 12: Home: 15: Mobile Unit: 19: Off CampusOutpatient Hospital: 20: Iris Furniture products - up to 30% Off | eBay, Iris Furniture - Up to 30% Off + FREE shipping | eBay, Up to 40% off all Iris Furniture Products discounted at eBay, Get average $24.37 on promotion items | Logan's Roadhouse, Get Free Favorites box plus 4 trays of chicken and free shipping, Up to 70% off Myrtle Beach Vacation Rentals, Enjoy up to 75% savings on Surfside Beach Rentals at Garden City Realty. How often are dental cleanings necessary? The description of different treatment categories, and the inclusion of particular services in a treatmentcategory,is not advice that any particular treatment category is the right treatment for you or that you should not obtain any particular treatment. Please write us using the comments form below or contact us page with the details of your dental billing matter. Dentists, by virtue of their clinical education, experience and professional ethics, are the people responsible for the diagnosis. Prefabricated stainless steel crown with resin window, Prefabricated esthetic coated stainless steel crown primary tooth. Limited orthodontic treatment of the primary dentition, Limited orthodontic treatment of the transitional dentition, Limited orthodontic treatment of the adolescent dentition, Limited orthodontic treatment of the adult dentition, Interceptive orthodontic treatment of the primary dentition, Interceptive orthodontic treatment of the transitional dentition, Comprehensive orthodontic treatment of the transitional dentition, Comprehensive orthodontic treatment of the adolescent dentition, Comprehensive orthodontic treatment of the adult dentition, Minor Treatment to Control Harmful Habits. The Content cannot, and is not intended to, replace the relationship that you have with yourhealth careprofessionals. Sealants are covered for tooth numbers/letters 2, 3, 4, 5, 12, 13, 14, 15, 18, 19, 20, 21, 28, 29, 30, 31, A, B, I, J, K, L, S, and T. Sealants are covered for tooth numbers: 2, 3, 14, 15, 18, 19, 30, and 31. For each crown (whi includes a "crown to hi noble, buildup for crown, and 1 surface composite), the insurance pays $557 altogether and the dentist charges $1275, so I will . hXn8}}gH Hf&M2Ll~(hHII>K8iLJ"{/y9RFHZr2NR0LXR4EDb=J-{Kz|H3P>4uBeFm=$:Qu&vhlYGEpEc@4|f_%"1hPOf8G.8$oXE{;q0TUnu0X.
nu Incision and drainage of abscess intraoral soft tissue. 0000070862 00000 n
Sign in to get a more accurate range that includes in-network savings. Reimbursement is allowable only for services that meet all program requirements. 0000081044 00000 n
Medicaid reimbursement is allowable only for services that meet all program requirements. Contact your company's human resources department. U\$6hXttOg}wuNNc0t8a1+v3ij9)&@^WS1m;h=RXY|v+r=u\3+=Ih ]?JXO4oK"I-8IiU 6vi@xC{zGtB"
E0bM5eu|nGE
yl 0000017097 00000 n
"}},{"@type":"Question","name":"What is D2391 Dental Code? To find out additional fee information on common procedures in your area, the process is simple just enter your dental service providers office zip code, then click on . Fee. $52.00. DENTAL FEE SCHEDULE Effective 01/01/2020 Print Date: 05/05/2020 Current Dental Terminology (including procedure codes, nomenclature, descriptors and other data contained therein) Pricing does not include cutbacks, assessment fees, etc. The Content on this website is not medical advice. 0000008475 00000 n
D0120 - Periodic Oral Evaluation. %PDF-1.5
%
This includes documenting the medical necessity of services in the members medical record. D2620 Dental Code GUID TISS REGEN-NONRESORB BARRIER PER SITE, SUBEPITHELIAL CONNECTIVE TISS GFT (INCL DONOR), DIST/PROX WEDGE PROC (NOT W/PROC IN SAME AREA), COMBINED CONNECTIVE TISSUE AND DOUBLE PEDICLE GRAFT, PERIODONTAL SCALING & ROOT PLANING PER QUADRANT, PERIODONTAL SCALING AND ROOT PLANING - 1-3 TEETH PER QD, FULL MOUTH DEBRID-ENABLE PERIODONTAL EVAL & DX, LOCALIZ DELIV CHEMO-CREVICULAR TISS PER TOOTH BR, PERIODONTAL MAINT PROC (FOLLOWING ACTIVE THERAP), MAXIL PART DENTURE-RESIN BASE(INCLD CLASP-RESTS), MANDIB PART DENTURE-RESIN BASE(INCLD CLASP-REST), MAXIL PART DENTURE-CAST METAL FRAME W/RESIN BASE, MANDIB PART DENTURE-CAST METAL FRAME W/RES BASE, REMOV UNILAT PART DENTURE-1 PIECE CAST METAL, REPLACE MISS/BRKN TEETH-COMPLT DENTURE(EA TOOTH), REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MAXILLARY), REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MANDIBULAR), REPLACEMENT OF REPLACEABLE PART OF SEMI-PRECISION ATTACH, SURG PLACEMENT IMPLANT BODY: ENDOSTEAL IMPLANT, ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN, ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN, ABUT SUPP PORCELAIN TO MTL CROWN PREDOM BASE MTL, ABUT SUPP PORCELAIN TO METAL CROWN NOBLE METAL, ABUTMENT SUPP CAST METAL CROWN HIGH NOBLE METAL, ABUTMENT SUPP CAST METAL CROWN PREDOM BASE METAL, ABUTMENT SUPP CAST METAL CROWN NOBLE METAL, IMPLANT SUPPORTED PORCELAIN/CERAMIC CROWN, IMPLANT SUPPORTED PORCELAIN FUSED TO METAL CROWN, ABUTMENT SUPPORTED RETAINER FOR PORCELAIN/CERAMIC CROWN, ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO HIGH NOBLE, IMPLANT SUPPORTED RETAINER FOR PORCELAIN FUSED TO HIGH NOBLE, IMPL MAINT PROC REMV CLEANS PROSTH&ABUTS REINS, REPLACE.
State Of Maryland Benefits Guide 2022,
Articles D