EMPLOYEE GROUP INSURANCE RENEWALS/LONG TERM DISABILITY, MEDICAL, DENTAL, VISION, EMPLOYEE ASSISTANCE, GROUP LIFE/ ACCIDENTAL DEATH/DISMEMBERMENT - 2014

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Resin -based composite restorations- direct D2330 Resin -based composite — one surface, anterior D2331 Resin -based composite — two surfaces, anterior D2332 Resin -based composite — three surfaces, anterior D2335 Resin -based composite — four or more surfaces or involving incisal angle (anterior) D2390 Resin -based composite crown, anterior D2391 Resin -based composite — one surface, posterior D2392 Resin -based composite — two surfaces, posterior D2393 Resin -based composite — three surfaces, posterior D2394 Resin -based composite — four or more surfaces, posterior Gold foil restorations D2410 Gold foil — one surface D2420 Gold foil — two surfaces D2430 Gold foil — three surfaces Inlay /onlay restorations D2510 Inlay — metallic — one surface D2520 Inlay — metallic — two surfaces D2530 Inlay — metallic — three or more surfaces D2542 Onlay — metallic — two surfaces D2543 Onlay — metallic — three surfaces D2544 Onlay — metallic — four or more surfaces D2610 Inlay — porcelain /ceramic — one surface D2620 Inlay — porcelain /ceramic — two surfaces D2630 Inlay — porcelain /ceramic — three or more surfaces D2642 Onlay — porcelain /ceramic — two surfaces D2643 Onlay — porcelain /ceramic — threesurfaces D2644 Onlay — porcelain /ceramic — four or more surfaces D2650 Inlay — resin -based composite — one surface D2651 Inlay — resin -based composite — two surfaces D2652 Inlay — resin -based composite — three or more surfaces D2662 Onlay — resin -based composite — two surfaces D2663 Onlay — resin -based composite — three surfaces D2664 Onlay — resin -based composite — four or more surfaces Crowns — single restorations only D2710 Crown — resin -based composite (indirect) D2712 Crown — 3/4 resin -based composite (indirect) D2720 Crown — resin with high noble metal D2721 Crown — resin with predominantly base metal D2722 Crown — resin with noble metal D2740 Crown — porcelain /ceramic substrate D2750 Crown — porcelain fused to high noble metal D2751 Crown — porcelain fused to predominantly base metal D2752 Crown — porcelain fused to noble metal D2780 Crown — 3/4 cast high noble metal D2781 Crown — 3/4 cast predominantly base metal D2782 Crown — 3/4 cast noble metal D2783 Crown — 3/4 porcelain /ceramic D2790 Crown — full cast high noble metal D2791 Crown — full cast predominantly base metal D2792 Crown — full cast noble metal D2794 Crown — titanium D2799 Provisional crown- further treatment or completion of a diagnosis necessary prior to final impression CDT2015 (Eff. 01- 01 -15)