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Last modified
3/27/2018 10:28:51 AM
Creation date
3/27/2018 10:16:23 AM
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Contracts
Company Name
DELTA DENTAL
Contract #
A-2018-021
Agency
PERSONNEL SERVICES
Council Approval Date
2/6/2018
Expiration Date
12/31/2019
Destruction Year
2024
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D2000 - D2999 RESTORATIVE <br />Amalgam restorations (including polishing) <br />D2140 Amalgam - one surface, primary or permanent <br />D2150 Amalgam - two surfaces, primary or permanent <br />D2160 Amalgam - three surfaces, primary or permanent <br />D2161 Amalgam - four or more surfaces, primary or permanent <br />Resin -based composite restorations -direct <br />D2330 Resin -based composite - one surface, anterior <br />D2331 Resin -based composite -- two surfaces, anterior <br />D2332 Resin -based composite - three surfaces, anterior <br />D2335 Resin -based composite - four or more surfaces or Involving Inclsal angle (anterior) <br />D2390 Resln-based composite crown, anterior <br />D2391 Resin -based composite - one surface, posterior <br />D2392 Resin -based composite - two surfaces, posterior <br />D2393 Resin -based composite - three surfaces, posterior <br />D2394 Resin -based composite - four or more surfaces, posterior <br />Gold foil restorations <br />D2410 Gold foil - one surface <br />D2420 Gold foil - two surfaces <br />D2430 Gold foil - three surfaces <br />Inlay/onlay restorations <br />D2510 Inlay - metallic - one surface <br />D2520 Inlay - metallic - two surfaces <br />02530 Inlay - metallic - three or more surfaces <br />D2542 Onlay - metallic - two surfaces <br />D2543 Onlay - metallic - three surfaces <br />D2544 Onlay - metallic - four or more surfaces <br />D2610 Inlay - porcelain/ceramic - one surface <br />D2620 Inlay - porcelain/ceramlc - two surfaces <br />D2630 Inlay - porcelain/ceramlc - three or more surfaces <br />D2642 Onlay - porcelain/ceramlc - two surfaces <br />D2643 Onlay - porcelain/ceramic - three surfaces <br />D2644 Onlay - porcelain/ceramic - four or more surfaces <br />D2650 Inlay - resin -based composite - one surface <br />D2651 Inlay - resin -based composite - two surfaces <br />D2652 Inlay - resin -based composite - three or more surfaces <br />D2662 Onlay - resin -based composite - two surfaces <br />D2663 Onlay - resin -based composite - three surfaces <br />D2664 Onlay - resin -based composite - four or more surfaces <br />Crowns -- single restorations only <br />D2710' Crown - resin -based composite (indirect) <br />D2712 Crown - 3/4 resin -based composite (Indirect) <br />D2720 Crown - resin with high noble metal <br />D2721 Crown - resin with predominantly base metal <br />D2722 Crown - resin with noble metal <br />D2740 Crown - porcelain/ceramic <br />D2750 Crown - porcelain fused to high noble metal <br />D2751 Crown - porcelain Fused to predominantly base metal <br />D2752 Crown - porcelain fused to noble metal <br />D2780 Crown - 3/4 cast high noble metal <br />D2781 Crown - 3/4 cast predominantly base metal <br />D2782 Crown - 3/4 cast noble metal <br />D2783 Crown - 3/4 porcelaln/ceramlc <br />CDT2018 (Eff. 01-01-18) <br />25C-7$ <br />
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