| Document Date: 2014-08-08 18:07:18
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City ANTERIOR RESIN / POSTERIOR RESIN / / Company UNILATERAL PARTIAL DENTURE-ONE PIECE CAST METAL / CAST NOBLE METAL / PA Description PERIODIC ORAL EXAM ESTABLISHED PATIENT LIMITED / LABIAL VENEER (RESIN LAMINATE)LABORATORY LABIAL VENEER (PORCELAIN LAMINATE)LABORATORY / / Facility INCLUDES COMPLETED ROOT CANAL / SURGICAL PROCEDURE FOR ISOLATION OF TOOTH WITH RUBBER DAM / / IndustryTerm PREVENTION OF ORAL DISEASE / / MedicalCondition ROOT RESORPTION / OF ORAL DISEASE / AIDS / / Organization American Dental Association / THERAPEUTIC RESTORATIONPRIMARY DENTITION RESTORATIVE FOUNDATION FOR AN INDIRECT RESTORATION CORE BUILDUP / / Position DENTIST / / Product APEXIFICATION/RECALCIFICATIONINTERIM MEDICATION / / Technology ULTRASOUND / HYBRIDIZATION / MRI / SIMULATION / /
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DENTAL FEE SCHEDULE Effective[removed]Print Date: [removed]Mississippi Medicaid dental fees are set at the Ingenix® Dental Customized Fee Analyzer Report 60th percentile minus 41% effective for dates of service beg