Stayplate ada code. March 15, 2012, is also the compliance date for using the 2010 Standards A Stay Plate is a temporary partial denture used while the gums and supporting bone are healing after an extraction, and before getting a partial denture. States establish and administer their own Medicaid programs and determine the type, amount, duration, and scope of services within broad federal guidelines. external opening of canal Periodontal Benefit: (codes 4210 – 4910) up to $2,000 yearly maximum Implant Benefit: (codes 6010, 6040 & 6050 only) Payable up to $2000 per tooth with a lifetime maximum of $3500. Contact Us. The Valplast Nesbit tooth replacement is safer but not without risk. 00 90% 0140 Limited Oral Eval – Problem Focused 52. Please complete the form to request a pick-up or call us at 1-877-452-4767. Dental coding is based on Current Dental Terminology codes which are governed by the American Dental Association. 00 90% 0210 Full Mouth X-Ray w/bitewings (once every 2 years) 112. Your dental professional or a third-party company creates Essex retainers from an impression or mold of your teeth, custom-made for your smile. The American Dental Association may periodically change CDT Codes or defi nitions. Order Now and Use Coupon Code Save40 to Receive 40% Off Your Order. I personally prefer the term “dentures” to dental plate, mainly because I believe plates should stay out of people’s mouths, such as license plates, dinner plates, and special religious golden plates. 00 6066 Implant Supported Porcelain Fused to Metal Crown (Titanium, Titanium Alloy Condition in which there is a deviation from or interruption of the normal structure or function of the dental tissues or teeth. ICD-10-CM K08. 625" 5/8" spine 7/16" 9 1/16" 9 1/16" 11" CDT 201 6 Companion: Help Guide and Training Manual CDT 2016 Companion Help Guide and Training Manual You and your dental team are first in line to ensure that patient records and claims Snap-On Smile Promo. Diff erent codes may be used to describe these covered procedures. 00 MY SMILE DENTAL PLAN FEE SCHEDULE Code Description Schedule CODE PROCEDURE DESCRIPTION LSP40809 PREMIER ACCESS ALLOWANCE ($) Page 1 LSP40809 D0120 Periodic Exam 23. North America CODE PROCEDURE DESCRIPTION PCA 10 PREMIER ACCESS ALLOWANCE ($) Page 1 PCA 10 – 03/07 5820 Interim Partial Denture - Upper ( Stayplate ) 288. authorize or provide the enrollee with outpatient dental services under HCPCS codes D7210, D2330, D2332, D2750, D5281, and D5212. Mandatory benefits include services including Dental Services for the Blind or Disabled. 00 CODE PROCEDURE DESCRIPTION MSP50809 PREMIER ACCESS ALLOWANCE ($) D5820 Interim Partial Denture - Upper ( Stayplate ) 325. 00 5821 Interim Partial Denture - Lower ( Stayplate ) 288. IV /Twilight Sleep. 14. PROCEDURE OR SERVICE. Full denture. D1527: Space maintainer—Removable – bilateral, mandibular. Your dental provider must check with Denti-Cal to find out if you have reached the $1800 cap before treating you. final restoration) 425 975 550 D3330 Root canal therapy - molar (excl. 04/28/2022 . D0412: Blood glucose level test—In-office using a glucose meter. It looks so real and it’s not big and bulky. $218. pATlENT: ADDRESS: CITY: PROCEDURE BITE BLOCK FRAME/ BITE TRY-IN W/ TEETH SENT AGE : ZIP CODE: DUE DONT FORGET: a Name a … Understanding abutments. 012 Tracheostomy for face, mouth and neck diagnoses or The interim denture approach is only slightly more time-consuming and expensive than the conventional immediate denture approach, yet it has many advantages. (Additional statutory authority: Social Services Law, Section 363-a) (a) Maximum reimbursable allowances for dental services except those dental services provided in certain dental clinics as set forth in subdivision (b) of this section and those provided in organized clinics in hospitals as set forth in sub-division (c) of … CODE PROCEDURE DESCRIPTION CV10809 PREMIER ACCESS ALLOWANCE ($) Page 2 CV10809F D2751† Porcelain/Predominantely Base Metal Crown 820. The enrollee’s supporting diagnosis was “diverticulosis of the colon” (ICD-9-CM code 562. 00 D5862 precision attachment, by report $ 488. A dental plate is another name for dentures. 00: 02381 d5820 interim partial denture (maxilary)d5821 interim partial denture (mandibular)a flipper/ stayplate is a temporary removable partial denturetypically fabricated out of hard acrylic, the same As codes are revised and updated, Member benefits may be modified to reflect the revised code, including a change in the actual code number when appropriate. 00: 02331: Resin—two surfaces, anterior: $92. $58. 00 MY SMILE DENTAL PLAN FEE SCHEDULE Code Description Schedule The Nesbit partial used to be made with metal clasps, which added to the risk because these prongs could easily create a puncture in the digestive tract, causing a very serious situation that could require surgical intervention. We provide everything you need from Rx forms to shipping resources. I would rate the best single tooth replacement Dental Masters Laboratory makes it quick and easy to send your case to us. 9 is grouped within Diagnostic Related Group (s) (MS-DRG v39. 00 D5851 tissue conditioning, mandibular $ 131. 18), have a valid Provider Agreement with the CSHCN Services Program, have completed the … D5822 teeth-extra (stayplate) $ 38. 00 D6066 Implant Supported Porcelain Fused to Metal Crown (Titanium, Titanium Alloy, High Noble Metal CODE PROCEDURE DESCRIPTION PCA 10 PREMIER ACCESS ALLOWANCE ($) Page 1 PCA 10 – 03/07 5820 Interim Partial Denture - Upper ( Stayplate ) 288. Annual Maximum = $2,000. The ADA Code: Description: Allowance: 02330: Resin—one surface, anterior: $75. The term “dental plate” is only used by people who like to make single words into two. Introduction. Cart: $ 0. 5 Maximum reimbursable dental fee schedules. Among those advantages are the following: (1) allows rapid results; (2) results in a higher quality definitive denture; (3) allows the surgical treatment to be performed during one Board Certified dental specialists ENDODONTICS (Root Canal Therapy) D3310 Root canal therapy - anterior tooth (excl. A Stay Plate will replace the missing tooth or teeth, and can assist with chewing and/or speaking until the partial denture is delivered. 1. Federal law requires states to provide certain mandatory benefits and allows states the choice of covering other optional benefits. 1818 Delta Dental of North Carolina | Dental Insurance Sending your case to Kairos Dental Lab is an easy and streamlined process. Learn vocabulary, terms, and more with flashcards, games, and other study tools. This is the American ICD-10-CM version of K02. 00 D2782 ¾ Cast Noble Metal 680. (stayplate) 175 5850/5851 Tissue conditioning … The entry of standardized treatment codes (ADA Current Dental Terminology, 5309 Teeth U/L Stayplate (706) Z1405 Missing Teeth 252 1. 00 D0145 Oral Evaluation for a Patient Under Three Years of Age and Counseling with Primary Caregiver 34. 00 90% 0130 Emergency Exam 85. external opening of canal Dental. (c) Additional service limitations and exclusions are maintained in the Coverage and Reimbursement Code Look-up Tool and the Dental, Oral Maxillofacial, and Orthodontia Services Utah Medicaid Provider Manual. Not Ordering Now ? Enter your email below to receive future Discount Coupon Codes. 05850/05851. ADA Codes Test. It shouldn’t be “sugar-coated” to say it is easy and wonderful. OPEN -or- INCORRECT, BITE. 3244 Phone: 408. 00 90% Flipper/Stayplate/Bridge Temporary Implant Bone Graft Facts. 00 90% 0150 Exam (once every 6 months, 180 days) 66. BRIDGES AND PONTICS STAYPLATE 120MM AISI 316 ASP0001200021. Benefit CODE PROCEDURE DESCRIPTION MSP50809 PREMIER ACCESS ALLOWANCE ($) D5820 Interim Partial Denture - Upper ( Stayplate ) 325. IN HOUSE MEMBERSHIP PLANS. You should receive a notice from Denti-Cal any time a service is denied. Dec. Order Update Portal. These regulations adopted revised, enforceable accessibility standards called the 2010 ADA Standards for Accessible Design, "2010 Standards. com. FLD. Intravenous Sedation. Benefit trained dental assistant, and you will need to adjust to wearing the flipper. To enroll in the CSHCN Services Program, dental providers must be actively enrolled in Texas Medicaid, maintain an active license status with the Texas State Board of Dental Examiners (TSBDE) (see Title 22 Texas Administrative Code (TAC), §§110. The listing of a code does not imply that the service described by the code is a covered or non-covered health service. Once the gum has healed, final abutments are placed so the prosthesis can be joined with the implant. 9 became effective on October 1, 2021. 5120 Complete denture-mand. Z1405 Missing Teeth 212 1. Getting your traditional or digital case on its way only takes a few minutes, because every resource you may need is compiled in one DENTAL OFFICE: LABORA TORY RX PROARTS DENTAL LABORATORIES 75470 E VALLEY BLVD CITY OF INDUSTRY, CA 97746 (626) 333-3531 Fax (626) 899-4799 www. 012 Tracheostomy for face, mouth and neck diagnoses or D5212 (mandibular stayplate). Healing abutments (also called healing cuffs or caps) help gum tissue heal around the implant site. 0 / 5. The following list(s) of procedure and/or diagnosis codes is provided for reference purposes only and may not be all inclusive. … ADA FEE BENEFIT CODES DESCRIPTION ALLOWANCE PAYMENT DIAGNOSTIC — (0110-0340) 0120 Periodic Exam 52. At the subsequent visit, the teeth will be removed and the stayplate will be delivered. proartsdental. COMFORT Soreness may develop in one or more areas of the gums, during the period of adjustment. You have a right to appeal any denied service. Current dental terminology 2009–10. Often it is used as a temporary tooth replacement while you wait for a dental bridge or for healing after a dental implant is placed. Call Health Consumer Alliance at … Answer (1 of 4): A transitional denture is an all acrylic partial denture that is used to transition a patient from a partial to a full denture. After delivery, it may require a few adjustment visits and some time for you Listing of a code in this guideline does not imply that the service described by the code is a covered or non -covered health service. 00 D6066 Implant Supported Porcelain Fused to Metal Crown (Titanium, Titanium Alloy, High Noble Metal Maxillary Partial – Resin Base - Dental Procedure Code Description. final restoration) 555 1100 545 D3410 Apicoectomy (per tooth) - first root 320 1025 705 services. 00 D6055 Dental Implant Supported Connecting Bar 382. 00 The entry of standardized treatment codes (ADA Current Dental Terminology, Teeth U/L Stayplate (706) Z1405: Missing Teeth: 252: 1: 5120: Complete denture-mand. Although stayplates are often used as temporary solution, many patients enjoy their reliable service indefinitely. S. 00 80% 5821 Lower stayplate - base fee (temporary stayplate used for cosmetic purposes not covered) 154. If your teeth were extracted today , do not remove the flipper until you return ADA FEE BENEFIT CODES DESCRIPTION ALLOWANCE PAYMENT DIAGNOSTIC — (0110-0340) 0120 Periodic Exam 52. 10). Here are the new CDT 2019 codes, effective January 1, 2019. … STAYPLATE 120MM AISI 316 ASP0001200021. It is made by taking an impression of your mouth, and then a plaster DENTAL PLANS WE ACCEPT. Each year, the … Flipper Stayplate Tooth Acrylic Partial Denture. SERVICES. ADA CODE D2740 CROWN, D2610 INLAY FOR 1 SURFACE, D2620 INLAY FOR 2 SURFACES, D2630 INLAY FOR 3 SURFACES, D2962 LABIAL VENEER, D2783 CROWN 3/4 PORCELAIN CERAMIC (DOES NOT INCLUDE VENEERS), Stayplate. At Cedar Dental Centre, we offer Complete and Partial Dentures, which are are custom fitted to properly fit your mouth. Call 519-621-3770. com CHECKLIST STATE. Please confirm your preferences. STAYPLATE. They’re constructed entirely of transparent plastic with no metal wires and are removable for meals and brushing. 00 6055 Dental Implant Supported Connecting Bar 370. K. 1 Enrollment. The entry of standardized treatment codes (ADA Current Dental Terminology, Teeth U/L Stayplate (706) Z1405: Missing Teeth: 252: 1: 5120: Complete denture-mand. A “partial” is a dental prosthetic that allows for the placement of a series of artificial teeth in an area where healthy teeth used to exist. Support Office hours: Monday-Friday 8am - 5pm Pacific Time Toll Free: 866. City-Data Forum Message Cancel Changes: Quick Reply The following errors occurred with your submission The interim denture approach is only slightly more time-consuming and expensive than the conventional immediate denture approach, yet it has many advantages. (b) Dental services are …. Acrylic Partial Denture. Dental, Oral and Maxillofacial Surgeons and Orthodontia. Getting your traditional or digital case on its way only takes a few minutes, because every resource you may need is compiled in one Something went wrong. As teeth are lost, they are added to the transitional denture until all the teet cabity within a bone filled w air and lined w mucus membran. For the actual text of the laws, (b) Dental services are subject to limitations and exclusions of medical necessity and utilization control considerations or conditions. The Handbook is provided to you in a Table of Contents format. D5282: Removable unilateral partial denture—One-piece cast metal, including clasps and teeth. They can be made from a variety of materials, and can contain as many teeth as are missing in either jaw. It’s also known as a stayplate and is considered a ‘temporary partial’. 9 may differ. Implant. New accoutns may request a … American Dental Coders Association 9015 W Union Hills Dr Ste 107 #314 Peoria, AZ 85382 (833) 469-2322 Dental Services. 05976. In the case of changed code numbers the Member shall still have the appropriate procedure as a benefit, as long as the benefit provided is the same. Conscious Sedation. As teeth are lost, they are added to the transitional denture until all the teet R414-49. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. meatus. 19-B of the Medicaid State Plan, as 8. I have a continuous smile. HealthCare Dental Maintenance Organization (DMO®) CODE PROCEDURE PATIENT PAYS CODE PROCEDURE PATIENT PAYS Office Visit Copay $5 RESTORATIVE 2330 Resin-1 Surface, Anterior No Charge (Stayplate) 4341 Periodontal Scaling & Root $40 5850-5851 Tissue Conditioning, $20 Planing per Quadrant (Limit of 4 Upper or Lower separate quadrants DELTA DENTAL PLAN (PPO & PREMIER) DELTACARE USA- PLAN (HMO) ELIGIBILITY You may receive services from any licensed dentist. If your teeth were extracted today , do not remove the flipper until you return Current And Past Dental Terminology For D7999. 00 D0140 Limited Oral Evaluation – Problem Focused 33. Please keep in mind that there is no such a thing as a perfect stayplate. 0): 011 Tracheostomy for face, mouth and neck diagnoses or laryngectomy with mcc. (Interim Denture) A dental flipper is the least expensive way to replace a missing tooth. The 2022 edition of ICD-10-CM K02. View cart for details. 00 USD I was a little on the questionable side but I will never use anyone else for my dental needs. 47 terms Aetna U. Academy of Prosthodontics. ADA Procedure Code. D1526: Space maintainer—Removable – bilateral, maxillary. Many patients opt not to have a stayplate for the back teeth during healing. Orthodontic Benefit: code 8080 or 8090, procedures 8462, 8660, 8670 and 8680, according to schedule up to $5,991 lifetime maximum Snap-On Smile Promo. A provisional prosthesis designed for use over a limited period of time, after which it is to be replaced by a more definitive restoration. 00 D2780 ¾ Cast High Noble Metal 699. Most common D7999 code reviews : Typical crown benefits for the replacement of an existing crown range from five to seven years before a replacement crown payment will be permitted, Scaling and debridement in the presence of inflammation or mucositis of a single implant, including leaning of the implant surfaces, … The California Medi-Cal Dental Program Provider Handbook, also known as the Handbook, is updated with the information from the Provider Bulletins each month. 00: 02335: Resin—four or more surfaces or involving incisal angle, anterior: $132. 00 D2752† Porcelain/Noble Metal Crown 820. It requires specific attachments, narratives, and information not readily needed on medical claims. 625" 5/8" spine 7/16" 9 1/16" 9 1/16" 11" CDT 201 6 Companion: Help Guide and Training Manual CDT 2016 Companion Help Guide and Training Manual You and your dental team are first in line to ensure that patient records and claims Dental. 00 Resequencing of CDT and CPT Codes The American Dental Association (ADA) and the American Medical Association (AMA) employ a resequenced numbering methodology. What You Should Know. Zak Dental Help Center. Personal DIY dental impression kits for custom teeth devices like retainers and mouth guards at half the price of dentists. The Code is periodically reviewed and revised to reflect the dynamic changes in dental procedures that are recognized by organized dentistry and the dental community as a whole. 00: 02332: Resin—three surfaces, anterior: $109. Special Tissue Conditioning, per Denture Unit Upper/Lower. 00 D2781 ¾ Cast Predominantly Base Metal 658. Among those advantages are the following: (1) allows rapid results; (2) results in a higher quality definitive denture; (3) allows the surgical treatment to be performed during one Code R414-49 - Dental, Oral and Maxillofacial Surgeons and Orthodontia; Utah Admin. It is more for cosmetic purposes and holding the other teeth from shifting. Pressure from a removable temporary can cause “dehiscence” which is the incision line opening in the bone graft becoming exposed…YIKES!! This is the worst thing that can happen to any type of bone graft whether it be a sinus lift bone graft Dental Services. (Examples: old CDT code 0130 The Code is also used on dental claims submitted on paper, and the ADA maintains a paper claim form whose data content reflects the HIPAA standard electronic dental claim. N20 or NITROUS OXIDE. K02. at 4, 5 n2. A temporary prosthesis inserted during or immediately following surgical Start studying Common Terms for Dental Procedures. • Appeals. 00 90% 5820 Upper stayplate - base fee (temporary stayplate used for cosmetic purposes not covered) 154. The following suggestions will help to answer some questions you may have. Approval Date: December 9, 2020 . ADA FEE BENEFIT CODES DESCRIPTION ALLOWANCE PAYMENT DIAGNOSTIC — (0110-0340) 0120 Periodic Exam 52. At Best Dental Results, we are always ready to respond to the changing The Stayplate Treatment. The coding and sending of claims is a unique process. Simply download and include the promotional Rx form below to redeem. SMILE GALLERY. d5820 interim partial denture (maxilary) d5821 interim partial denture (mandibular) a flipper/ stayplate is a temporary removable partial denture typically fabricated out of hard acrylic, the same ADA Insurance Codes for Laboratory Procedures: CROWN & BRIDGE Inlay/Onlay Restorations D2510 Inlay - metallic - one surface D2520 Inlay - metallic - two surfaces D2530 Inlay - metallic - three or more surfaces D2542 Onlay - metallic - two surface D2543 Onlay - metallic - three surfaces D2544 Onlay - metallic - four or more surfaces A stayplate is an acrylic removable partial denture and it’s an excellent low cost option when a patient needs to replace one tooth or several teeth. 00 D2783 ¾ Porcelain/Ceramic 719. 00 D5850 tissue conditioning, maxillary $ 131. MATERIALS: Acrylic, teeth, possible wrought wire clasps. Section 8 - Fraud, Abuse, and Quality of Care First, dental billing is waaaayyyyy different than medical billing. Dental caries, unspecified. YOU MIGHT ALSO LIKE 64 terms. 1–110. Interim stayplate: Code D5820. 18), have a valid Provider Agreement with the CSHCN Services Program, have completed the … Managed Dental Guard Other codes may be used to describe Covered Services. final restoration) 555 1100 545 D3410 Apicoectomy (per tooth) - first root 320 1025 705 authorized procedure performed by a registered dental assistant shouldbe performed under general or direct supervision, except as provided in Section 1777. Id. 0 (3) 3 total reviews. trained dental assistant, and you will need to adjust to wearing the flipper. City-Data Forum > General Forums > Health and Wellness > Dental Health: Eating with a stay plate (teeth, implants, painful, molar) User Name: Remember Me: Password Please counties, and zip codes on our site: City-data. Abutments can be placed at the same time as the implant (1-stage surgery). 00: 02336: Composite resin crown anterior—primary: $125. DIAGNOSTIC TREATMENT Stayplate, Including Teeth and Clasps. This impression is then sent to the dental laboratory. Benefit D5820 Temporary Partial – Stayplate Denture Upper; D5821 Temporary Partial – Stayplate Denture Lower Become a Reseller Contact Us. 9 - other international versions of ICD-10 K02. X. 00 D0150 Comprehensive Oral Exam – New or Established Patient 23. The amount paid is STAYPLATE 50% Up to 50% No Cost DENTURE ADJUSTMENTS 50% Up to 50% No Cost DENTURE RELINE 50% Up to 50% DENTURE AND PARTIAL REPAIRS 50% Up to 50% No Cost DENTURE DUPLICATION Board Certified dental specialists ENDODONTICS (Root Canal Therapy) D3310 Root canal therapy - anterior tooth (excl. Applicable Codes . We want your interactions with us to be hassle-free and easy for every case, which is why we have streamlined our case submission process. Benefit coverage for health services is determined by the member specif ic benefit plan document and applicable laws American Dental Association (ADA) CDT Codebook 2022. The MAO is required to provide the diagnostic, 535. 00 D5822 teeth-extra (stayplate) $ 38. 8. Full Lower Denture. Dental Masters Laboratory makes it quick and easy to send your case to us. Provide your patients with a full or partial cosmetic solution that easily snaps over their preexisting dentition. ** If five or more x-ray films (intraoral, bitewing) are taken during an 5820 Temporary partial-stayplate denture (upper) 300 750 5821 Temporary partial-stayplate denture (lower) 315 750 Flipper. A dental flipper is made out of acrylic. Synonymous terminology: Obturator, surgical stayplate, immediate temporary obturator. Or they can be placed during a second AL SH HPol-Dental 01 1 NY Aetna Life Insurance Company Student Dental Insurance Policy The student dental insurance policy (“student policy”) is by and between Aetna Life Insurance Company (Aetna, we, us, or our) and Columbia University (Policyholder, you, or your) Student policy number: 696730 Date of issue: 02/23/22 Benefits. 00 D5982 surgical stent $ 375. Flipper Stayplate Tooth Acrylic Partial Denture 5. November 5, 2018 by Ramsey Amin. Z1405: American Dental Association. A temporary prosthesis inserted during or immediately following surgical Delta Dental of North Carolina | Dental Insurance * Comprehensive oral exam ADA CODE # 150 replaces ADA CODE # 110 initial oral exam. About Us. If you are not a local account, you may request a pick-up with UPS here or call 1-800-PICKUPS to schedule a UPS Pickup!. 354. 00; Navigation. 00: 02380: Resin—one surface, posterior—primary: $78. Not Covered. (1) Introduction and Authority. Code R414-49-3 - Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Temporary dentures or temporary stayplate partial dentures; (u) Limited orthodontic treatment, including removable appliance therapies; The stayplate is “ok” for chewing when you are having multiple molars replaced. 00 6066 Implant Supported Porcelain Fused to Metal Crown (Titanium, Titanium Alloy Resequencing of CDT and CPT Codes The American Dental Association (ADA) and the American Medical Association (AMA) employ a resequenced numbering methodology. … 05820 Denture—temporary (partial-stayplate), upper 05821 Denture—temporary (partial-stayplate), lower 05830 Obturator for surgically excised palatal tissue Dental Services. 92032 809111 a 11/09 DC-07-2- … ADA FEE BENEFIT CODES DESCRIPTION ALLOWANCE PAYMENT DIAGNOSTIC — (0110-0340) 0120 Periodic Exam 52. Maximum Benefit Payable Per Procedure. The sections of law noted below are contained in the Dental Practice Act locatedin Chapter 4 of Division 2 of the California Business and Professions Code (BPC). Fortunately, the temporary time is Answer (1 of 4): A transitional denture is an all acrylic partial denture that is used to transition a patient from a partial to a full denture. The Medicaid Dental Program provides a scope of dental services for Medicaid recipients in accordance with the Dental, Oral Maxillofacial, and Orthodontia Services Utah Medicaid Provider Manual and Attachment 4. Section 7 - Codes (Revision Date May 2022) | Tags: Provider Handbook. " On March 15, 2012, compliance with the 2010 Standards was required for new construction and alterations under Titles II and III. H. com proartsdental@gmail. 00 90% 0220 Single film 30. Save $100 off $550 for full arch or $300 for partial arch. Essix retainers are unique in their low-profile appearance. Stage: Delivery Adjust wire clasps. R414-49-1. Approval Date: December 8, 2021 . ** If high noble metal is used, there will be an additional patient charge for the actual cost of the high noble metal. Interim Stayplate. 00 cabity within a bone filled w air and lined w mucus membran. final restoration) 358 875 517 D3320 Root canal therapy - bicuspid (excl. Regular price From $140. 00 D5821 Interim Partial Denture - Lower ( Stayplate ) 325. (a) This section defines the scope of dental services available to blind or disabled Medicaid members who are 18 years of age or older.


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