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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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06114 Implant/ abutment supported fixed denture for edentulous arch - maxillary <br />06115 Implant / abutment supported fixed denture for edentulous arch - mandibular <br />D6116 Implant / abutment supported fixed denture for partially edentulous arch - maxlliary <br />D6117 Implant / abutment supported fixed denture for partially edentulous arch - mandibular <br />D6118 Implant/abutment supported interim fixed denture for edentulous arch - mandibular <br />D6119 Implant/abutment supported Interim fixed denture for edentulous arch - maxillary <br />06190 Radiographic/surgical implant Index, by Report <br />D6093 Re -cement or re -bond Implant/abutment supported fixed partial denture <br />D6194 Abutment supported retainer crown for FPD - (titanium) <br />D6199 Unspecified Implant procedure, by report <br />D6200 - D6999 PROSTHODONTICS, FIXED <br />(Each retainer and each pontic constitutes a unit in a fixed partial denture) <br />Fixed partial denture pontics <br />D6205 Pontic - indirect resin based composite <br />06210 Pontic - cast high noble metal <br />D6211 Pontic - cast predominantly base metal <br />D6212 Pontic - cast noble metal <br />D6214 Pontic - titanium <br />D6240 Pontic - porcelain fused to high noble metal <br />D6241 Pontic - porcelain fused to predominantly base metal <br />D6242 Pontic - porcelain fused to noble metal <br />D6245 Pontic - porcelain/ceramic <br />D6250 Pontic - resin with high noble metal <br />D6251 Pontic - resin with predominantly base metal <br />D6252 Pontic - resin with noble metal <br />D6253 Provisional pontic - further treatment or completion of a diagnosis necessary prior to <br />Impression. <br />Fixed partial denture retainers - Inlays/ onlays <br />D6545 Retainer - cast metal for resin bonded fixed prosthesis <br />D6548 Retainer - porcelain/ceramlc for resin bonded fixed prosthesis <br />D6549 Resin retainer- for resin bonded fixed prosthesis <br />06600 Retainer inlay - porcelain/ceramic, two surfaces <br />D6601 Retainer Inlay - porcelain/ceramic, three or more surfaces <br />D6602 Retainer inlay - cast high metal, two surfaces <br />D6603 Retainer inlay - cast high metal, three or more surfaces <br />D6604 Retainer Inlay - cast predominantly base metal, two surfaces <br />D6605 Retainer Inlay -, cast predominantly base metal, three or more surfaces <br />D6606 Retainer inlay - cast noble metal, two surfaces <br />D6607 Retainer inlay - cast noble metal, three or more surfaces <br />D6608 Retainer onlay - porcelain/ceramic, two surfaces <br />D6609 Retainer onlay - porcelain/ceramic, three or more surfaces <br />D6610 Retainer onlay - cast high noble metal, two surfaces <br />D6611 Retainer onlay - cast high noble metal, three or more surfaces <br />D6612 Retainer onlay - cast predominantly base metal, two surfaces <br />D6613 Retainer onlay - cast predominantly base metal, three or more surfaces <br />D6614 Retainer onlay - cast noble metal, two surfaces <br />D6615 Retainer onlay - cast noble metal, three or more surfaces <br />D6624 Retainer Inlay - titanium <br />D6634 Retainer onlay - titanium <br />Fixed partial denture retainers - crowns <br />D6710 <br />Retainer crown - Indirect resin based composite <br />D6720 <br />Retainer crown - resin with high noble metal <br />D6721 <br />Retainer crown - resin with predominantly base metal <br />D6722 <br />Retainer crown - resin with noble metal <br />rn} <br />10 cDT201a (Eff, 01-01-15) <br />260-86 <br />
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