WebD2932 Prefabricated Resin Crown $56.45 Y; $56.45 Y; $56.45 Y; D2933 Prefabricated Stainless Steel crown with resin window $56.45 N; N/A N/A; HFS Dental Program Fee Schedule for Children and Adult Beneficiaries Effective July 1, 2024 All services not covered are noted as N/A and will not have prior authorization requirement. Webd2932 prefabricated resin crown $65.70 d2933 prefabricated stainless steel crown with resin window $149.12 d2934 prefabricated esthetic coated stainless steel crown - primary tooth $149.12 d2940 protective restoration $34.95 d2950 core buildup, including any pins when required $43.00

Virginia Smiles for Children Schedule of Allowable Fees

WebD2932 Prefabricated Resin Crown 75.00 D2933 Prefabricated Stainless Steel Crown with Resin Window 81.00 D2934 Prefabricated Esthetic Coated Stainless Steel Crown – Primary Tooth 154.00 D2940 Protective Restoration 50.00 D2950 Core Buildup, Including Any Pins When Required 81.00 D2951 Pin Retention – Per Tooth, In Addition to … WebFeb 10, 2024 · D2931 Prefabricated stainless steel crown - permanent tooth 165.56 D2932 Prefabricated resin crown 180.87 D2933 Prefabricated stainless steel crown with … cure rochester ny menu

Pre-fabricated Crown Benefits and Criteria SC DHHS

WebJun 29, 2024 · We are proud to announce that the ADA has issued a new code: D2929. Specifically designated as a prefabricated … The revised benefits apply to all the pre-fabricated crowns with codes D2929, D2930, D2931, D2932 and D2934, currently covered under the South Carolina State Medicaid Plan as described below: The SCDHHS is also revising the criteria for placement of a pre-fabricated crown. WebD2932 Prefabricated resin crown $85.00 $136.00 D2940 Protective restoration $110.00 $99.00 D2950 Core buildup, including any pins when required $120.00 NPB D2951 Pin retention, per tooth, in addition to restoration $60.00 NPB D2952 Post and core in addition to crown, indirectly fabricated $132.00 NPB easy food for teens