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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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D6740 Retainer crown - porcelain/ceramic <br />D6750 Retainer crown - porcelain fused to high noble metal <br />D6751 Retainer crown - porcelain fused to predominantly base metal <br />D6752 Retainer crown - porcelain fused to noble metal <br />D6780 Retainer crown - 3/4 cast high noble metal <br />D6781 Retainer crown - 3/4 cast predominantly base metal <br />D6782 Retalner crown - 3/4 cast noble metal <br />D6783 Retainer crown - 3/4 porcelain/ceramic <br />D6790 Retalner crown - full cast high noble metal <br />D6791 Retalner crown - full cast predominantly base metal <br />D6792 Retalner crown - full cast noble metal <br />D6793 Provisional retainer crown - further treatment of completion or a diagnosis necessary <br />prior to Pnal Impression <br />D6794 Retainer crown - titanium <br />Other fixed partial denture services <br />D6920 Connector bar <br />D6930 Re -cement or re -bond fixed partial denture <br />D6940 Stress breaker <br />D6950 Precision attachment <br />D6980 Fixed partial denture repair necessitated by restorative material <br />D6985 Pediatric partial denture, Rxed <br />D6999 Unspecified, fixed prosthodontic procedure, by report <br />i <br />D7000 - D7999 ORAL AND MAXILLOFACIAL SURGERY <br />Extractions (includes local anesthesia, suturing, If needed, and routine postoperative care) <br />D7111 Extractlon, coronal remnants - primary tooth <br />D7140 Extraction, erupted tooth or exposed root (elevation and/or forceps removal) <br />Surgical extractions (Includes local anesthesia, suturing, If needed, and routine <br />postoperative care) <br />D7210 Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and <br />Including elevation of mucoperiosteal Flap if indicated <br />D7220 Removal of Impacted tooth - soft tissue <br />D7230 Removal of Impacted tooth - partially bony <br />D7240 Removal of impacted tooth - completely bony <br />D7241 Removal of impacted tooth - completely bony, with unusual surgical complications <br />D7250 Removal of residual tooth roots (cutting procedure) <br />Other surgical procedures <br />D7260 Oroantral flstual closure <br />D7261. Primary closure of a sinus perforation <br />D7270 Tooth reimplantation and/or stabilization of accidentally evulsed or displaced tooth <br />D7272 Tooth transplantation (includes reimplantation from one site to another and splinting <br />and/or stabilization) <br />D7280 Exposure of an unerupted tooth <br />D7282 Mobilization of erupted or malposltloned tooth to aid eruption <br />D7283 Placement of device to facilitate eruption of Impacted tooth <br />D7285 Inclslonal biopsy of oral tissue - hard (bone, tooth) <br />D7286 Inclslonal biopsy of oral tissue - soft <br />D7287 Exfoilative cytological sample collection <br />D7288 Brush biopsy - transeplthellal sample collection <br />D7290 Surgical repositioning of teeth <br />D7291 Transseptal fiberotomy/supra crestal fiberotomy, by report <br />D7292 Placement of temporary anchorage device [screw retained plate] requiring Flap; <br />Includes device removal <br />D7293 Placement of temporary anchorage device requiring flap; includes device removal <br />11 EDT2018 (Eff. 01-01-18) <br />25C-86 <br />
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