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DELTA DENTAL
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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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D6040 Surgical placement: eposteal Implant <br />D6050 Surgical placement: transosteal Implant <br />Implant supported prosthetics <br />D6055 Dental Implant supported connecting bar <br />D6056 Prefabricated abutment - Includes modification and placement <br />D6057 Custom fabricated abutment - Includes placement <br />D6058 Abutment supported porcelain/ceramic crown <br />D6059 Abutment supported porcelain fused to metal crown (high noble metal) <br />D6060 Abutment supported porcelain fused to metal crown (predominantly base metal) <br />D6061 Abutment supported porcelain fused to metal crown (noble metal) <br />D6062 Abutment supported cast metal crown (high noble metal) <br />06063 Abutment supported cast metal crown (predominantly base metal) <br />D6064 Abutment supported cast metal crown (noble metal) <br />D6065 Implant supported porcelain/ceramic crown <br />D6066 Implant supported porcelain fused to metal crown (titanium, titanium alloy, high noble <br />metal) <br />D6067 Implant supported metal crown (titanium, titanium alloy, high noble metal) <br />D6068 Abutment supported retainer for porcelain/ceramic FPD <br />D6069 Abutment supported retainer for porcelain fused to metal FPD (high noble metal) <br />D6070 Abutment supported retainer for porcelain fused to metal FPD (predominantly base <br />metal) <br />D6071 Abutment supported retainer for porcelain fused to metal FPD (noble metal) <br />D6072 Abutment supported retainer for cast metal FPD (high noble metal) <br />D6073 Abutment supported retainer for cast metal FPD (predominantly base metal) <br />D6074 Abutment supported retainer for cast metal FPD (noble metal) <br />D6075 Implant supported retainer for ceramic FPD <br />D6076 Implant supported retainer for porcelain fused. to metal FPD (titanium, titanium alloy, <br />or high noble metal) <br />D6077 Implant supported retainer for cast metal FPD (titanium, titanium alloy, or high noble <br />metal) <br />Other Implant services <br />D6080 Implant maintenance procedures, Including removal of prosthesis, cleansing of <br />prosthesis and abutments and reinsertion of prosthesis <br />D6081 Scaling and debridement in the presence of Inflammation or mucositis of a single <br />Implant, Including cleaning of the Implant surfaces, without flap entry and closure <br />D6085 Provisional Implant crown <br />D6090 Repair implant supported prosthesis, by report <br />D6091 Replacement of semi-precislon or precision attachment (male or female component) of <br />implant/abutment supported prosthesis, per attachment <br />D6092 Re -cement or re -bond Implant/abutment supported crown <br />D6094 Abutment supported crown - (titanium) <br />D6095 Repair Implant abutment, by report <br />D6096 Remove broken Implant retaining screw <br />D6100 Implant removal, by report <br />D6101 Debridement of a perilmplant defect or defects surrounding a single Implant, and <br />surface cleaning of the exposed implant surraces, including flap entry and closure <br />D6102 Debridement and osseous contouring of a periimplant defect or defects surrounding a <br />single Implant, and surface cleaning includes surface cleaning of the exposed Implant <br />surfaces, Including flap entry and closure <br />D6110 Implant/abutment supported removable denture for edentulous arch- maxillary <br />D6111 Implant/abutment-supported removable denture for edentulous arch- mandibular <br />D6112 Implant/abutment supported rem ovabl e. denture for partially edentulous arch - <br />maxillary <br />D6113 Implant/abutment supported removable denture for partially edentulous arch - <br />mandibular <br />CDT201S(M 01-01-19) <br />• <br />
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