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EMPLOYEE GROUP INS. RENEWALS -2012
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EMPLOYEE GROUP INS. RENEWALS -2012
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Last modified
2/16/2017 12:29:05 PM
Creation date
7/12/2013 10:31:02 AM
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Contracts
Company Name
EMPLOYEE GROUP INS. RENEWALS
Contract #
A-2012-170
Agency
PERSONNEL SERVICES
Council Approval Date
8/6/2012
Expiration Date
12/13/2013
Destruction Year
2018
Notes
Amends A-2002-208 Amended by A-2014-176, A-2015-206, A-2015-207
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<br />Other restorative services <br />D2910 Recement inlay, onlay, or partial coverage restoration <br />D2915 Recement cast or prefabricated post and core <br />D2920 Recement crown <br />D2930 Prefabricated stainless steel crown - primary tooth <br />D2931 Prefabricated stainless steel crown - permanent tooth <br />D2932 Prefabricated resin crown <br />D2933 Prefabricated stainless steel crown with resin window <br />D2934 Prefabricated esthetic coated stainless steel crown - primary tooth <br />D2940 Sedative filling <br />D2950 Core buildup, including any pins <br />D2951 Pin retention - per tooth, in addition to restoration <br />D2952 Post and core in addition to crown, indirectly fabricated <br />D2953 Each additional indirectly fabricated post - same tooth <br />D2954 Prefabricated post and core in addition to crown <br />D2955 Post removal (not in conjunction with endodontic therapy) <br />D2957 Each additional prefabricated post - same tooth <br />D2960 Labial veneer (resin laminate) - chairside <br />D2961 Labial veneer (resin laminate) - laboratory <br />D2962 Labial veneer (porcelain laminate) - laboratory <br />D2970 Temporary crown (fractured tooth) <br />D2971 Additional procedures to construct new crown under existing partial denture framework <br />D2975 Coping <br />D2980 Crown repair, by report <br />D2999 Unspecified restorative procedure, by report <br />D3000 - D3999 ENDODONTICS <br />Pulp capping <br />D3110 Pulp cap - direct (excluding final restoration) <br />D3120 Pulp cap - indirect (excluding final restoration) <br />Pulpotomy <br />D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the <br />dentinocemental junction and application of medicament <br />D3221 Pulpal debridement, primary and permanent teeth <br />D3222 Partial pulpotomy for apexogenesis-permanent tooth with incomplete root development <br />D3230 Pulpal therapy (resorbable filling) - anterior, primary tooth (excluding final restoration) <br />D3240 Pulpal therapy (resorbable filling) - posterior, primary tooth (excluding final restoration) <br />Endodontic therapy on primary teeth (including treatment plan, clinical procedures and <br />follow-up care) <br />D3310 Endodontic therapy, anterior tooth (excluding final restoration) <br />D3320 Endodontic therapy, bicuspid tooth (excluding final restoration) <br />D3330 Endodontic therapy, molar tooth (excluding final restoration) <br />D3331 Treatment of root canal obstruction; non-surgical access <br />D3332 Incomplete endodontic therapy; inoperable, unrestorable or fractured tooth <br />D3333 Internal root repair of perforation defects <br />Endodontic retreatment <br />D3346 Retreatment of previous root canal therapy - anterior <br />D3347 Retreatment of previous root canal therapy - bicuspid <br />D3348 Retreatment of previous root canal therapy - molar
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