CODE SERVICE FREQUENCY BENEFIT DETAILS D2390 White-colored filling that Unlimited 1 procedure per tooth every 5 replaces entire outer years surface of a front tooth D2391 White-colored filling on Unlimited 1 procedure per surface per D2392 middle or back teeth tooth every 2 years D2393 D2394 Crowns D2740 Cap (crown) made of Unlimited 1 crown code or bridge retainer D2750 metal, porcelain, porcelain code (see covered bridge codes D2752 fused to metal or titanium below) per tooth every 5 years D2753 D2790 D2792 D2794 Other Crown Services D2910 Recement (reglue) an old Unlimited 1 procedure per tooth every 2 inlay, onlay, veneer or calendar years partial crown that has fallen off D2920 Recement (reglue) an old Unlimited 1 procedure per tooth every 2 crown that has fallen off calendar years, only covered 6 months after initial placement of crown D2940 Protective filling to relieve Unlimited 1 procedure per tooth per pain or promote healing, lifetime which is usually meant to be a temporary solution D2950 Buildup filling that is Unlimited 1 buildup procedure code placed to prepare a tooth (D2950, D2952, D2954) per for a new cap (crown) tooth every 5 years, not covered when a separate filling code is billed on the same tooth on the same day 4