The patient, presented to the dental provider's office for evaluation and treatment of tooth #4,18,19,20,21, and 22. Radiographic images show that #18 and 19 have extensive decay involving the cusps. The patient is missing tooth #21 while teeth #20 and 22 have no evidence of decay. . The health plan's determination of medical necessity is overturned in part. The requested health service/treatment of porcelain fused to base metal crown (2751) for teeth #18 and 19 is medically necessary. For sites #20 and 22, there is no evidence of decay, there is only a missing tooth. As such, the treatment of a fixed partial denture is not medically necessary.