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25C - AGMT GROUP INSURANCE
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25C - AGMT GROUP INSURANCE
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Last modified
2/1/2018 7:02:12 PM
Creation date
2/1/2018 7:10:52 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Personnel Services
Item #
25C
Date
2/6/2018
Destruction Year
2023
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D5222 Immediate mandibular partial denture - resin base (including any conventional clasps, <br />rests and teeth) <br />D5223 Immediate maxillary partial denture - cast metal framework with resin denture bases <br />(Including any conventional clasps, rests and teeth) <br />D5224 Immediate mandibular partial denture - cast metal framework with resin denture <br />bases (including any conventional clasps, rests and teeth) <br />D5225 Maxillary partial denture - flexible base (Including any clasps, rests and teeth) <br />D5226 Mandibular partial denture - flexible base (Including any clasps, rests and teeth) <br />D5281 Removable unilateral partial denture - one piece cast metal (including clasps and <br />teeth) <br />Adjustments to dentures <br />D5410 Adjust complete denture - maxillary <br />D5411 Adjust complete denture - mandibular <br />D5421 Adjust partial denture - maxillary <br />D5422 Adjust partial denture - mandibular <br />Repairs to complete dentures <br />D5511 Repair broken complete denture base, mandibular <br />D5512 Repair broken complete denture base, maxillary <br />D5520 Replace missing or broken teeth - complete denture (each tooth) <br />Repairs to partial dentures <br />D5611 <br />Repair resin partial denture base, mandibular <br />D5612 <br />Repair resin partial denture base, maxillary <br />D5621 <br />Repair cast partial framework, mandibular <br />D5622 <br />Repair cast partial framework, maxillary <br />D5630 <br />Repair or replace broken clasp - per tooth <br />D5640 <br />Replace broken teeth - per tooth <br />D5650 <br />Add tooth to existing partial denture <br />D5660 <br />Add clasp to existing partial denture - per tooth <br />D5670 <br />Replace all teeth and acrylic on cast metal framework (maxillary) <br />D5671 <br />Replace all teeth and acrylic on cast metal framework (mandibular) <br />Denture rebase procedures <br />D5710 <br />Rebase complete maxillary denture <br />D5711 <br />Rebase complete mandibular denture <br />D5720 <br />Rebase maxillary partial denture <br />D5721 <br />Rebase mandibular partial denture <br />Denture reline procedures <br />D5730 <br />Reline complete maxillary denture (chairside) <br />D5731 <br />Reline complete mandibular denture (chairside) <br />D5740 <br />Reline maxillary partial denture (chairside) <br />D5741 <br />Reline mandibular partial denture (chairside) <br />D5750 <br />Reline complete maxillary denture (laboratory) <br />D5751 <br />Reline complete mandibular denture (laboratory) <br />D5760 <br />Reline maxillary partial denture (laboratory) <br />D5761 <br />Reline mandibular partial denture (laboratory) <br />Interim prosthesis <br />D5810 <br />Interim complete denture (maxlllary) <br />D5811 <br />Interim complete denture (mandibular) <br />D5820 <br />Interim partial denture (maxlllary) <br />D5821 <br />Interim partial denture (mandibular) <br />CDT2018 (Eff. 01-01-18) <br />25C-82 <br />
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