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2020/12/16 Council Agenda Packet
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2020/12/16 Council Agenda Packet
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Council Agenda Packet
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12/16/2020
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D4910 Periodontic maintenance <br />6. Prosthodontics - Removable <br />D5110 Complete denture - maxillary <br />D5120 Complete denture - mandibular <br />D5130 Immediate denture - maxillary <br />D5140 Immediate denture - mandibular <br />D5211 Maxillary partial denture - resin base (including any retentive/clasping materials, rests and <br />teeth) <br />D5212 Mandibular partial denture - resin base (including any retentive/clasping materials, rests <br />and teeth) <br />D5213 Maxillary partial denture - cast metal framework with resin denture bases (including any <br />retentive/clasping materials, rests and teeth) <br />D5214 Mandibular partial denture - cast metal framework with resin denture bases (including any <br />retentive/clasping materials, rests and teeth) <br />D5282 Removable unilateral partial denture - one piece cast metal (including clasps and teeth), <br />maxillary <br />D5283 Removable unilateral partial denture - one piece cast metal (including clasps and teeth), <br />mandibular <br />D5410 Adjust complete denture - maxillary <br />D5411 Adjust complete denture - mandibular <br />D5421 Adjust partial denture - maxillary <br />D5422 Adjust partial denture - mandibular <br />D5511 Repair broken complete denture base, mandibular <br />D5512 Repair broken complete denture base, maxillary <br />D5520 Replace missing or broken teeth - complete denture (each tooth) <br />D5611 Repair resin partial denture base, mandibular <br />D5612 Repair resin partial denture base, maxillary <br />D5621 Repair cast partial framework, mandibular <br />D5622 Repair cast partial framework, maxillary <br />D5630 Repair or replace broken retentive/clasping materials - per tooth <br />D5640 Replace broken teeth - per tooth <br />D5650 Add tooth to existing partial denture <br />D5660 Add clasp to existing partial denture — per tooth <br />D5670 Replace all teeth and acrylic on cast metal framework (maxillary) <br />D5671 Replace all teeth and acrylic on cast metal framework (mandibular) <br />D5710 Rebase complete maxillary denture <br />D5711 Rebase complete mandibular denture <br />D5720 Rebase maxillary partial denture <br />D5721 Rebase mandibular partial denture <br />D5730 Reline complete maxillary denture (chairside) <br />D5731 Reline complete mandibular denture (chairside) <br />D5740 Reline maxillary partial denture (chairside) <br />D5741 Reline mandibular partial denture (chairside) <br />D5750 Reline complete maxillary denture (laboratory) <br />D5751 Reline complete mandibular denture (laboratory) <br />D5760 Reline maxillary partial denture (laboratory) <br />D5761 Reline mandibular partial denture (laboratory) <br />D5810 Interim complete denture (maxillary) <br />D5811 Interim complete denture (mandibular) <br />D5820 Interim partial denture (maxillary) <br />D5821 Interim partial denture (mandibular) <br />D5850 Tissue conditioning, maxillary <br />D5851 Tissue conditioning, mandibular <br />D5863 Overdenture - complete maxillary <br />D5864 Overdenture - partial maxillary <br />so <br />$300 <br />$300 <br />$300 <br />$300 <br />$300 <br />$300 <br />$300 <br />$300 <br />$300 <br />$300 <br />so <br />$0 <br />$0 <br />$0 <br />$0 <br />so <br />so <br />$0 <br />$0 <br />$0 <br />$0 <br />so <br />so <br />$0 <br />$0 <br />$0 <br />$0 <br />$0 <br />$0 <br />$0 <br />$0 <br />$0 <br />$0 <br />$0 <br />so <br />so <br />$0 <br />$0 <br />$0 <br />$150 <br />$150 <br />$150 <br />$150 <br />$0 <br />$0 <br />$300 <br />$300 <br />Current Dental Terminology (CDT) 0 2020 American Dental Association. <br />All rights reserved. <br />001 L-WA811(5/20) 26 <br />
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