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[DOCX File]Department of Budget and Management
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Code** Description** Copayment Appointments. None Office visit - during regularly scheduled hours*** 10.00. D9440 Office visit - after regularly scheduled hours 40.00. None Missed appointment without 24-hour notice*** 25.00. D0120 Periodic oral evaluation (once in any six calendar months) No Charge. D0140 Limited oral evaluation, problem ...
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[DOC File]KC4182FL Secure Choice Individual Copayment Schedule - FL
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HCPCS Code Description TOS M1 M2 Diag List Review PA MP. Y/N S0518 Sunglasses frames D 00 00 N N N Y V2623 Prosthetic eye, plastic, custom D 00 00 N N N Y V2629 Prosthetic eye, other type D 00 00 N N N Y Payable HCPCS Procedure Codes for Optical Dispensing Contractor. HCPCS Code Description TOS M1 M2 Diag List Review PA MP
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Code Tip: D7880 Occlusal Orthotic Device, By Report CDT 2017 - e…
code: procedure description; d0364. cone beam ct capture and interpretation with limited field of view - less than one whole jaw. ... palliative (emergency) treatment of dental pain - minor procedures. d9940. occlusal guards, by report. d9999. unspecified adjunctive procedure, by report.
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The Commonwealth of Massachusetts
Feb 15, 2018 · Code Allowed Fee Allowed Fee (EPSDT-eligible members) Description I. Diagnostic D0120 $20 $29 Periodic oral evaluation - established patient D0140 $39 $49 Limited oral evaluation - problem focused D0145 I.C. I.C. Oral evaluation for a patient under three years of age and counseling with primary caregiver D0150 $37 $58 Comprehensive oral ...
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[DOC File]MAINE MEDICAL ASSISTANCE MANUAL
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DENTAL BENEFITS: FUNCTIONAL AREA 1 – DHMO. Solicitation No. F10B340000517FA1 Attachment T-4 (Amendment 6) Solicitation No. F10B340000547FA1 Attachment T-8b. Solicitation No. F10
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[DOC File]Official Notice DMS-05-W-1
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The department promulgated an Emergency Rule which amended the provisions of the April 15, 2013 Emergency Rule in order to revise the formatting of these provisions as a result of the promulgation of the June 1, 2013 Emergency Rule to assure that these provisions are promulgated in a clear and concise manner in the Louisiana Administrative Code ...
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[DOCX File]Provider_Fee_Schedule
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Code Description under age 21 & all ICF-MR residents* age 21 & over when allowed under 25.04 under age 21 & all ICF-MR residents age 21 & over when allowed under 25.04 Additional Limits Max Allow D0340 Cephalometric Film NO NO Included as part of “records” in comprehensive orthodontics, not covered separately; hospitals use revenue codes to ...
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[DOCX File]Home Page | Department of Vermont Health Access
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Administrative Bulletin 19-03. 101 CMR 314.00: Dental Services. Effective January 1, 2019. Updated CDT Dental Codes. Pursuant to 101 CMR 314.01(5) and (6), the Executive Office of Health and Human Services (EOHHS) has added 15 codes, deleted four codes (which have been cross-walked to eight new codes), and revised descriptions for seven codes as specified in the 2019 Current Dental Terminology ...
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Procedure Code
Prepaid Dental. Good news about dental benefits for members of ... ADA Code** Service Description** Member Copayment Appointments ... each additional 15 minutes 40.00 D9940 Occlusal guard, by report* 95.00 D9951 Occlusal adjustment - limited 55.00 D9952 Occlusal adjustment - complete 280.00 Bleaching D9972 External bleaching - per arch 185.00 ...
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[DOC File]Prepaid Dental
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CODE. DENTAL PROCEDURE DESCRIPTION. UNITS FROM. UNITS TO. VALUE. D0120. Periodic Oral Evaluation - Established Patient. 1. 999. 29.08. D0140. Limited Oral Evaluation ...
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D9940 dental code description