Crowns. 1. Metal and/or porcelain/ceramic crowns and crown build-ups limited to one (1) per sixty (60) months per tooth. 2. Metal and/or porcelain/ceramic inlays and onlays limited to one (1) per sixty (60) months per tooth. 3. Stainless steel crowns. 4. Recementation of crowns and/or inlays limited to once in any twelve (12) month period.
Appears in 4 contracts
Sources: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement, Individual Enrollment Agreement
Crowns. 1. Metal and/or porcelain/ceramic crowns and crown build-ups limited to one (1) per sixty (60) 60 months per tooth.
2. Metal and/or porcelain/ceramic inlays and onlays limited to one (1) per sixty (60) 60 months per tooth.
3. Stainless steel crowns.
4. Recementation of crowns and/or inlays limited to once in any twelve (12) month period.
Appears in 2 contracts
Sources: Student Health Plan Individual Enrollment Agreement, Student Health Plan Individual Enrollment Agreement