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Agmt98 Delta Dental
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Agmt98 Delta Dental
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Last modified
7/5/2005 2:59:37 PM
Creation date
5/20/2005 2:45:37 PM
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Template:
Agreement
Contractor Name
Delta Dental
PROJECT NAME
coverage for police officers & sergeants
RMP File Number
304
Date
2/2/1998
Reso Ref
13279
Box
5933
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<br />.-_.-- <br /> <br />------- -. . <br /> <br />Partial dentures (including routine postdelivery care) <br /> <br />05211 <br /> <br />05212 <br /> <br />05213 <br /> <br />05214 <br /> <br />05281 <br /> <br />Upper partial denture resin base (including any <br />conventional clasps, rests and teeth) <br />Lower partial denture resin base (including any <br />conventional clasps, rests and teeth) <br />Upper partial denture -- metal base with resin saddles <br />(including any conventional clasps, rests and teeth) <br />Lower partial denture -- metal base with resin saddles <br />(including any conventional clasps, rests and teeth) <br />Removable unilateral partial denture -- one piece metal <br />base casting, clasp attachments -- per unit (including <br />pontics) <br /> <br />Adjustments to dentures <br /> <br />05410 <br />05411 <br />05421 <br />05422 <br /> <br />Adjust <br />Adjust <br />Adjust <br />Adjust <br /> <br />complete denture -- upper <br />complete denture -- lower <br />partial denture -- upper <br />partial denture -- lower <br /> <br />Repairs to complete dentures <br /> <br />05510 <br />05520 <br /> <br />Repair broken complete denture base <br />Replace missing or broken teeth -- complete denture (each <br />tooth) <br /> <br />Repairs to partial dentures <br /> <br />05610 <br />05620 <br />05630 <br />05640 <br />05650 <br />05660 <br /> <br />Repair resin saddle or base <br />Repair cast framework, by report <br />Repair or replace broken clasp <br />Replace broken teeth -- per tooth <br />Add tooth to existing partial denture <br />Add clasp to existing partial denture <br /> <br />Denture rebase procedures <br /> <br />05710 <br />05711 <br />05720 <br />05721 <br /> <br />----- --.--- <br /> <br />--.- <br /> <br />Rebase <br />Rebase <br />Rebase <br />Rebase <br /> <br />complete upper denture <br />complete lower denture <br />upper partial denture <br />lower partial denture <br /> <br />6 <br /> <br />---- ----- <br /> <br />--.u - -- <br /> <br />---.-----.-- <br /> <br />.. ____nun. <br />
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