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State of California Standard Plan (DHMO) DESCRIPTION OF BENEFITS AND COPAYMENTS The benefits shown below are performed as deemed appropriate by the attending Primary Care Dentist (“PCD”) subject to the limitations an
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Document Date: 2010-10-09 00:22:57


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Company

No Cost No Cost X. ORTHODONTICS Limited / dentition Limited / /

Currency

USD / /

Facility

Primary Care Dentist’s facility / Root canal / /

IndustryTerm

metal / metal crown / insurance benefit maximum / piece cast metal / noble metal / pathology laboratory services / base metal post / metal base / pedodontist services / stainless steel crown / /

MedicalCondition

tumor / neoplasms / cysts / root resorption / benign odontogenic cyst / pain / natural tooth loss / disorder / impacted tooth / infection / lateral exostosis / /

MedicalTreatment

Retreatment / amputation / counseling / surgery / tooth Retreatment / /

Organization

State government / /

Position

dentist / special anesthesiologist / Access Dental Plan orthodontist / panel dentist / physician / Care Dentist / requesting dentist / ADJUNCTIVE GENERAL SERVICES / orthodontist / /

Product

Nikon D5000 Digital Camera / Nikon D3000 Digital Camera / D1120 Prophylaxis / /

RadioStation

Core / /

SocialTag