Price Schedule updated.xlsx
XLSX spreadsheet 29 KB Posted
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- 36C24823Q1289
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| File | Type | Posted |
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| 36C24823Q1289 0001.docx | DOCX document | |
| PRICE SCHEDULE.xlsx | XLSX spreadsheet | |
| 36C24823Q1289.pdf | ||
| 36C24823Q1289_1.docx | DOCX document | |
| Past Performance Questionnaire 36C24823Q1289.docx | DOCX document | |
| PWS Dental Prosthesis.pdf |
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Sheet1
| Item Number | Description | Contract Period | Estimated Quantity | Unit of Measure | Unit Price | Total Price | |
| 0001 | ATLG Atlantis Gold Hue Abutment | Base | 3 | EA | |||
| 0002 | ATLT Atlantis Titanium Abutment | Base | 3 | EA | |||
| 0003 | ATLZ Atlantis Zirconia Abutment | Base | 3 | EA | |||
| 0004 | ENCT Encode Titanium Abutment | Base | 3 | EA | |||
| 0005 | NEOTI Neodent Titanium Abutment | Base | 5 | EA | |||
| 0006 | NEOZI Neodent Zirconia Abutment | Base | 4 | EA | |||
| 0007 | PROT Nobel Procera Titanium Abutment | Base | 4 | EA | |||
| 0008 | STRCAD Straumann CadCam Titanium Abutment | Base | 6 | EA | |||
| 0009 | STRT Straumann Titanium Abutment | Base | 5 | EA | |||
| 0010 | FCZ Brux Full Contour Zirconia | Base | 5 | EA | |||
| 0011 | CELT Celtra Crown | Base | 22 | EA | |||
| 0012 | CELTI Celtra Inlay | Base | 22 | EA | |||
| 0013 | CELTV Celtra Veneer | Base | 15 | EA | |||
| 0014 | FCZV Full Contour Zirconia Veneer | Base | 12 | EA | |||
| 0015 | EMAX IPS Emax Crown | Base | 12 | EA | |||
| 0016 | EMAXV IPS Emax Veneer | Base | 12 | EA | |||
| 0017 | LEMAX Layered Emax Crown | Base | 21 | EA | |||
| 0018 | PMMA PMMA Temporary Crown | Base | 42 | EA | |||
| 0019 | PIO Porcelain Inlay Crown | Base | 31 | EA | |||
| 0020 | PFZ Porcelain to Zirconia Crown | Base | 31 | EA | |||
| 0021 | DW Diagnostic Waxup | Base | 42 | EA | |||
| 0022 | DDWU Digital Diagnostic Waxup | Base | 40 | EA | |||
| 0023 | FCC Full Cast Crown | Base | 43 | EA | |||
| 0024 | IN/ON Inlay/Onlay | Base | 28 | EA | |||
| 0025 | PFM Porcelain Fused to Metal Crown | Base | 40 | EA | |||
| 0026 | AF Acrylic Flipper | Base | 30 | EA | |||
| 0027 | AMG Athletic Mouth Guard | Base | 5 | EA | |||
| 0028 | CT Custom Tray | Base | 33 | EA | |||
| 0029 | ESSEX Essex Retainer | Base | 5 | EA | |||
| 0030 | HNG Hard Night Guard | Base | 15 | EA | |||
| 0031 | HSNG Hard/Soft Night Guard | Base | 12 | EA | |||
| 0032 | ISJ Implant Seating Jig | Base | 5 | EA | |||
| 0033 | ISG Implant Surgical Group | Base | 16 | EA | |||
| 0034 | ISS Implant Surgical Stent | Base | 14 | EA | |||
| 0035 | IVJ Implant Verification Jig | Base | 13 | EA | |||
| 0036 | LAP Lower Acrylic Partial Complete | Base | 28 | EA | |||
| 0037 | LDC Lower Denture Complete | Base | 28 | EA | |||
| 0038 | NTI NTI Appliance | Base | 11 | EA | |||
| 0039 | PBB Partial Bite Block | Base | 68 | EA | |||
| 0040 | REL Reline | Base | 48 | EA | |||
| 0041 | REP Repair | Base | 108 | EA | |||
| 0042 | SDREL Same Day Reline | Base | 12 | EA | |||
| 0043 | SREP Same Day Repair | Base | 12 | EA | |||
| 0044 | SNG Soft Night Guard | Base | 18 | EA | |||
| 0045 | SREL Soft Reline | Base | 15 | EA | |||
| 0046 | UAP Upper Acrylic Partial Complete | Base | 8 | EA | |||
| 0047 | UDC Upper Denture Complete | Base | 16 | EA | |||
| 0048 | DURC Duraflex Clasp | Base | 5 | EA | |||
| 0049 | DN Duraflex Nesbit | Base | 8 | EA | |||
| 0050 | JDUR Jump Duraflex | Base | 8 | EA | |||
| 0051 | LDURD Lower Duraflex Denture Complete | Base | 16 | EA | |||
| 0052 | LDUR Lower Duraflex Partial Complete | Base | 20 | EA | |||
| 0053 | RAFDUR Reset After Finish Duraflex Partial | Base | 12 | EA | |||
| 0054 | RARDUR-PRO Reset After Finish Duraflex-Proc | Base | 12 | EA | |||
| 0055 | RAFDUR-WTI Reset After Finish Duraflex-WTI | Base | 10 | EA | |||
| 0056 | UDURD Upper Duraflex Denture Complete | Base | 32 | EA | |||
| 0057 | UDUR Upper Duraflex Partial Complete | Base | 32 | EA | |||
| 0058 | DIMQ Digital Implant Model Quad | Base | 1 | EA | |||
| 0059 | DMQ Digital Model Quad | Base | 1 | EA | |||
| 0060 | TAP Tap 3 Appliance | Base | 17 | EA | |||
| 0061 | LPC Lower Partial Complete | Base | 21 | EA | |||
| 0062 | LPF Lower Partial Frame | Base | 48 | EA | |||
| 0063 | LVPF Lower Vitallium Partial Frame | Base | 11 | EA | |||
| 0064 | UPC Upper partial Complete | Base | 28 | EA | |||
| 0065 | UPF Upper Partial Frame | Base | 35 | EA | |||
| 0066 | UVPF Upper Vitallium Partial Frame | Base | 16 | EA | |||
| 0067 | PV Porcelain Veneer | Base | 11 | EA | |||
| 0068 | SRPMMA Scew Retained PMMA Temporary Crown | Base | 12 | EA | |||
| 0069 | OFPFM Open Face Crown | Base | 15 | EA | |||
| 0070 | CSM Ceramic Space Maintainer | Base | 1 | EA | |||
| 0071 | FASM Full Arch Space Maintainer | Base | 1 | EA | |||
| 0072 | HR Hawley Retainer | Base | 1 | EA | |||
| 0073 | EMA Myerson EMA | Base | 1 | EA | |||
| 0074 | NA Nance Appliance | Base | 1 | EA | |||
| 0075 | NES Nesbit | Base | 1 | EA | |||
| 0076 | LAB Labor | Base | 5 | EA | |||
| 0077 | DBB Denture Bite Block | Base | 78 | EA | |||
| 0078 | DPMS Duplicate Model and Seat | Base | 63 | EA | |||
| 0079 | IAP Immediate Acrylic Partial | Base | 10 | EA | |||
| 0080 | ID Immediate Denture | Base | 13 | EA | |||
| 0081 | IP Immediate Partial | Base | 5 | EA | |||
| 0082 | JD Jump Denture | Base | 5 | EA | |||
| 0083 | LAPLC Lower Acrylic Partial Lucitone Process | Base | 25 | EA | |||
| 0084 | LAPP Lower Acrylic Partial Process | Base | 13 | EA | |||
| 0085 | LAPS Lower Acrylic Partial Setup | Base | 10 | EA | |||
| 0086 | LDLP Lower Denture Lucitone Process | Base | 35 | EA | |||
| 0087 | LDP Lower Denture Process | Base | 38 | EA | |||
| 0088 | LDS Lower Denture Setup | Base | 33 | EA | |||
| 0089 | LDPP Lower Duraflex Partial Process | Base | 8 | EA | |||
| 0090 | LDPS Lower Duraflex Partial Setup | Base | 5 | EA | |||
| 0091 | LPLP Lower Partial Lulcitone Process | Base | 30 | EA | |||
| 0092 | LPP Lower Partial Process | Base | 60 | EA | |||
| 0093 | LPS Lower Partial Setup | Base | 48 | EA | |||
| 0094 | RELL Reline Lucitone | Base | 3 | EA | |||
| 0095 | Noble Alloy 61 | Base | 24.5 | EA | |||
| 0096 | PT Plastic Tooth | Base | 45 | EA | |||
| 0097 | RD Reset Denture | Base | 5 | EA | |||
| 0098 | RP Reset Partial | Base | 8 | EA | |||
| 0099 | UAPLC Upper Acrylic Partial lucitone Process | Base | 23 | EA | |||
| 0100 | UAPP Upper Acrylic partial Process | Base | 20 | EA | |||
| 0101 | UAPS Upper Acrylic Partial Setup | Base | 10 | EA | |||
| 0102 | UDLP Upper Denture Lucitone Process | Base | 63 | EA | |||
| 0103 | UDP Upper Denture Process | Base | 63 | EA | |||
| 0104 | UDS Upper Denture Setup | Base | 55 | EA | |||
| 0105 | UDPC Upper Duraflex Partial Complete | Base | 20 | EA | |||
| 0106 | UDPP Upper Duraflex Partical Process | Base | 8 | EA | |||
| 0107 | UDPS Upper Duraflex partial Setup | Base | 5 | EA | |||
| 0108 | UPLP Upper Partial Lucitone Process | Base | 23 | EA | |||
| 0109 | UPP Upper Partial Process | Base | 33 | EA | |||
| 0110 | UPS Upper Partial Process | Base | 25 | EA | |||
| 0111 | WP Weld Partial | Base | 5 | EA | |||
| 0112 | WWC Wrought Wire Clasp | Base | 138 | EA | |||
| 0113 | Yellow Full Cast | Base | 81 | EA | |||
| Total Price Base Year |
| 1001 | ATLG Atlantis Gold Hue Abutment | Option 1 | 3 | EA | |
| 1002 | ATLT Atlantis Titanium Abutment | Option 1 | 3 | EA | |
| 1003 | ATLZ Atlantis Zirconia Abutment | Option 1 | 3 | EA | |
| 1004 | ENCT Encode Titanium Abutment | Option 1 | 3 | EA | |
| 1005 | NEOTI Neodent Titanium Abutment | Option 1 | 5 | EA | |
| 1006 | NEOZI Neodent Zirconia Abutment | Option 1 | 4 | EA | |
| 1007 | PROT Nobel Procera Titanium Abutment | Option 1 | 4 | EA | |
| 1008 | STRCAD Straumann CadCam Titanium Abutment | Option 1 | 6 | EA | |
| 1009 | STRT Straumann Titanium Abutment | Option 1 | 5 | EA | |
| 1010 | FCZ Brux Full Contour Zirconia | Option 1 | 5 | EA | |
| 1011 | CELT Celtra Crown | Option 1 | 22 | EA | |
| 1012 | CELTI Celtra Inlay | Option 1 | 22 | EA | |
| 1013 | CELTV Celtra Veneer | Option 1 | 15 | EA | |
| 1014 | FCZV Full Contour Zirconia Veneer | Option 1 | 12 | EA | |
| 1015 | EMAX IPS Emax Crown | Option 1 | 12 | EA | |
| 1016 | EMAXV IPS Emax Veneer | Option 1 | 12 | EA | |
| 1017 | LEMAX Layered Emax Crown | Option 1 | 21 | EA | |
| 1018 | PMMA PMMA Temporary Crown | Option 1 | 42 | EA | |
| 1019 | PIO Porcelain Inlay Crown | Option 1 | 31 | EA | |
| 1020 | PFZ Porcelain to Zirconia Crown | Option 1 | 31 | EA | |
| 1021 | DW Diagnostic Waxup | Option 1 | 42 | EA | |
| 1022 | DDWU Digital Diagnostic Waxup | Option 1 | 40 | EA | |
| 1023 | FCC Full Cast Crown | Option 1 | 43 | EA | |
| 1024 | IN/ON Inlay/Onlay | Option 1 | 28 | EA | |
| 1025 | PFM Porcelain Fused to Metal Crown | Option 1 | 40 | EA | |
| 1026 | AF Acrylic Flipper | Option 1 | 30 | EA | |
| 1027 | AMG Athletic Mouth Guard | Option 1 | 5 | EA | |
| 1028 | CT Custom Tray | Option 1 | 33 | EA | |
| 1029 | ESSEX Essex Retainer | Option 1 | 5 | EA | |
| 1030 | HNG Hard Night Guard | Option 1 | 15 | EA | |
| 1031 | HSNG Hard/Soft Night Guard | Option 1 | 12 | EA | |
| 1032 | ISJ Implant Seating Jig | Option 1 | 5 | EA | |
| 1033 | ISG Implant Surgical Group | Option 1 | 16 | EA | |
| 1034 | ISS Implant Surgical Stent | Option 1 | 14 | EA | |
| 1035 | IVJ Implant Verification Jig | Option 1 | 13 | EA | |
| 1036 | LAP Lower Acrylic Partial Complete | Option 1 | 28 | EA | |
| 1037 | LDC Lower Denture Complete | Option 1 | 28 | EA | |
| 1038 | NTI NTI Appliance | Option 1 | 11 | EA | |
| 1039 | PBB Partial Bite Block | Option 1 | 68 | EA | |
| 1040 | REL Reline | Option 1 | 48 | EA | |
| 1041 | REP Repair | Option 1 | 108 | EA | |
| 1042 | SDREL Same Day Reline | Option 1 | 12 | EA | |
| 1043 | SREP Same Day Repair | Option 1 | 12 | EA | |
| 1044 | SNG Soft Night Guard | Option 1 | 18 | EA | |
| 1045 | SREL Soft Reline | Option 1 | 15 | EA | |
| 1046 | UAP Upper Acrylic Partial Complete | Option 1 | 8 | EA | |
| 1047 | UDC Upper Denture Complete | Option 1 | 16 | EA | |
| 1048 | DURC Duraflex Clasp | Option 1 | 5 | EA | |
| 1049 | DN Duraflex Nesbit | Option 1 | 8 | EA | |
| 1050 | JDUR Jump Duraflex | Option 1 | 8 | EA | |
| 1051 | LDURD Lower Duraflex Denture Complete | Option 1 | 16 | EA | |
| 1052 | LDUR Lower Duraflex Partial Complete | Option 1 | 20 | EA | |
| 1053 | RAFDUR Reset After Finish Duraflex Partial | Option 1 | 12 | EA | |
| 1054 | RARDUR-PRO Reset After Finish Duraflex-Proc | Option 1 | 12 | EA | |
| 1055 | RAFDUR-WTI Reset After Finish Duraflex-WTI | Option 1 | 10 | EA | |
| 1056 | UDURD Upper Duraflex Denture Complete | Option 1 | 32 | EA | |
| 1057 | UDUR Upper Duraflex Partial Complete | Option 1 | 32 | EA | |
| 1058 | DIMQ Digital Implant Model Quad | Option 1 | 1 | EA | |
| 1059 | DMQ Digital Model Quad | Option 1 | 1 | EA | |
| 1060 | TAP Tap 3 Appliance | Option 1 | 17 | EA | |
| 1061 | LPC Lower Partial Complete | Option 1 | 21 | EA | |
| 1062 | LPF Lower Partial Frame | Option 1 | 48 | EA | |
| 1063 | LVPF Lower Vitallium Partial Frame | Option 1 | 11 | EA | |
| 1064 | UPC Upper partial Complete | Option 1 | 28 | EA | |
| 1065 | UPF Upper Partial Frame | Option 1 | 35 | EA | |
| 1066 | UVPF Upper Vitallium Partial Frame | Option 1 | 16 | EA | |
| 1067 | PV Porcelain Veneer | Option 1 | 11 | EA | |
| 1068 | SRPMMA Scew Retained PMMA Temporary Crown | Option 1 | 12 | EA | |
| 1069 | OFPFM Open Face Crown | Option 1 | 15 | EA | |
| 1070 | CSM Ceramic Space Maintainer | Option 1 | 1 | EA | |
| 1071 | FASM Full Arch Space Maintainer | Option 1 | 1 | EA | |
| 1072 | HR Hawley Retainer | Option 1 | 1 | EA | |
| 1073 | EMA Myerson EMA | Option 1 | 1 | EA | |
| 1074 | NA Nance Appliance | Option 1 | 1 | EA | |
| 1075 | NES Nesbit | Option 1 | 1 | EA | |
| 1076 | LAB Labor | Option 1 | 5 | EA | |
| 1077 | DBB Denture Bite Block | Option 1 | 78 | EA | |
| 1078 | DPMS Duplicate Model and Seat | Option 1 | 63 | EA | |
| 1079 | IAP Immediate Acrylic Partial | Option 1 | 10 | EA | |
| 1080 | ID Immediate Denture | Option 1 | 13 | EA | |
| 1081 | IP Immediate Partial | Option 1 | 5 | EA | |
| 1082 | JD Jump Denture | Option 1 | 5 | EA | |
| 1083 | LAPLC Lower Acrylic Partial Lucitone Process | Option 1 | 25 | EA | |
| 1084 | LAPP Lower Acrylic Partial Process | Option 1 | 13 | EA | |
| 1085 | LAPS Lower Acrylic Partial Setup | Option 1 | 10 | EA | |
| 1086 | LDLP Lower Denture Lucitone Process | Option 1 | 35 | EA | |
| 1087 | LDP Lower Denture Process | Option 1 | 38 | EA | |
| 1088 | LDS Lower Denture Setup | Option 1 | 33 | EA | |
| 1089 | LDPP Lower Duraflex Partial Process | Option 1 | 8 | EA | |
| 1090 | LDPS Lower Duraflex Partial Setup | Option 1 | 5 | EA | |
| 1091 | LPLP Lower Partial Lulcitone Process | Option 1 | 30 | EA | |
| 1092 | LPP Lower Partial Process | Option 1 | 60 | EA | |
| 1093 | LPS Lower Partial Setup | Option 1 | 48 | EA | |
| 1094 | RELL Reline Lucitone | Option 1 | 3 | EA | |
| 1095 | Noble Alloy 61 | Option 1 | 24.5 | EA | |
| 1096 | PT Plastic Tooth | Option 1 | 45 | EA | |
| 1097 | RD Reset Denture | Option 1 | 5 | EA | |
| 1098 | RP Reset Partial | Option 1 | 8 | EA | |
| 1099 | UAPLC Upper Acrylic Partial lucitone Process | Option 1 | 23 | EA | |
| 1100 | UAPP Upper Acrylic partial Process | Option 1 | 20 | EA | |
| 1101 | UAPS Upper Acrylic Partial Setup | Option 1 | 10 | EA | |
| 1102 | UDLP Upper Denture Lucitone Process | Option 1 | 63 | EA | |
| 1103 | UDP Upper Denture Process | Option 1 | 63 | EA | |
| 1104 | UDS Upper Denture Setup | Option 1 | 55 | EA | |
| 1105 | UDPC Upper Duraflex Partial Complete | Option 1 | 20 | EA | |
| 1106 | UDPP Upper Duraflex Partical Process | Option 1 | 8 | EA | |
| 1107 | UDPS Upper Duraflex partial Setup | Option 1 | 5 | EA | |
| 1108 | UPLP Upper Partial Lucitone Process | Option 1 | 23 | EA | |
| 1109 | UPP Upper Partial Process | Option 1 | 33 | EA | |
| 1110 | UPS Upper Partial Process | Option 1 | 25 | EA | |
| 1111 | WP Weld Partial | Option 1 | 5 | EA | |
| 1112 | WWC Wrought Wire Clasp | Option 1 | 138 | EA | |
| 1113 | Yellow Full Cast | Option 1 | 81 | EA | |
| Total Price Option Year one |
| 2001 | ATLG Atlantis Gold Hue Abutment | Option 2 | 3 | EA | |
| 2002 | ATLT Atlantis Titanium Abutment | Option 2 | 3 | EA | |
| 2003 | ATLZ Atlantis Zirconia Abutment | Option 2 | 3 | EA | |
| 2004 | ENCT Encode Titanium Abutment | Option 2 | 3 | EA | |
| 2005 | NEOTI Neodent Titanium Abutment | Option 2 | 5 | EA | |
| 2006 | NEOZI Neodent Zirconia Abutment | Option 2 | 4 | EA | |
| 2007 | PROT Nobel Procera Titanium Abutment | Option 2 | 4 | EA | |
| 2008 | STRCAD Straumann CadCam Titanium Abutment | Option 2 | 6 | EA | |
| 2009 | STRT Straumann Titanium Abutment | Option 2 | 5 | EA | |
| 2010 | FCZ Brux Full Contour Zirconia | Option 2 | 5 | EA | |
| 2011 | CELT Celtra Crown | Option 2 | 22 | EA | |
| 2012 | CELTI Celtra Inlay | Option 2 | 22 | EA | |
| 2013 | CELTV Celtra Veneer | Option 2 | 15 | EA | |
| 2014 | FCZV Full Contour Zirconia Veneer | Option 2 | 12 | EA | |
| 2015 | EMAX IPS Emax Crown | Option 2 | 12 | EA | |
| 2016 | EMAXV IPS Emax Veneer | Option 2 | 12 | EA | |
| 2017 | LEMAX Layered Emax Crown | Option 2 | 21 | EA | |
| 2018 | PMMA PMMA Temporary Crown | Option 2 | 42 | EA | |
| 2019 | PIO Porcelain Inlay Crown | Option 2 | 31 | EA | |
| 2020 | PFZ Porcelain to Zirconia Crown | Option 2 | 31 | EA | |
| 2021 | DW Diagnostic Waxup | Option 2 | 42 | EA | |
| 2022 | DDWU Digital Diagnostic Waxup | Option 2 | 40 | EA | |
| 2023 | FCC Full Cast Crown | Option 2 | 43 | EA | |
| 2024 | IN/ON Inlay/Onlay | Option 2 | 28 | EA | |
| 2025 | PFM Porcelain Fused to Metal Crown | Option 2 | 40 | EA | |
| 2026 | AF Acrylic Flipper | Option 2 | 30 | EA | |
| 2027 | AMG Athletic Mouth Guard | Option 2 | 5 | EA | |
| 2028 | CT Custom Tray | Option 2 | 33 | EA | |
| 2029 | ESSEX Essex Retainer | Option 2 | 5 | EA | |
| 2030 | HNG Hard Night Guard | Option 2 | 15 | EA | |
| 2031 | HSNG Hard/Soft Night Guard | Option 2 | 12 | EA | |
| 2032 | ISJ Implant Seating Jig | Option 2 | 5 | EA | |
| 2033 | ISG Implant Surgical Group | Option 2 | 16 | EA | |
| 2034 | ISS Implant Surgical Stent | Option 2 | 14 | EA | |
| 2035 | IVJ Implant Verification Jig | Option 2 | 13 | EA | |
| 2036 | LAP Lower Acrylic Partial Complete | Option 2 | 28 | EA | |
| 2037 | LDC Lower Denture Complete | Option 2 | 28 | EA | |
| 2038 | NTI NTI Appliance | Option 2 | 11 | EA | |
| 2039 | PBB Partial Bite Block | Option 2 | 68 | EA | |
| 2040 | REL Reline | Option 2 | 48 | EA | |
| 2041 | REP Repair | Option 2 | 108 | EA | |
| 2042 | SDREL Same Day Reline | Option 2 | 12 | EA | |
| 2043 | SREP Same Day Repair | Option 2 | 12 | EA | |
| 2044 | SNG Soft Night Guard | Option 2 | 18 | EA | |
| 2045 | SREL Soft Reline | Option 2 | 15 | EA | |
| 2046 | UAP Upper Acrylic Partial Complete | Option 2 | 8 | EA | |
| 2047 | UDC Upper Denture Complete | Option 2 | 16 | EA | |
| 2048 | DURC Duraflex Clasp | Option 2 | 5 | EA | |
| 2049 | DN Duraflex Nesbit | Option 2 | 8 | EA | |
| 2050 | JDUR Jump Duraflex | Option 2 | 8 | EA | |
| 2051 | LDURD Lower Duraflex Denture Complete | Option 2 | 16 | EA | |
| 2052 | LDUR Lower Duraflex Partial Complete | Option 2 | 20 | EA | |
| 2053 | RAFDUR Reset After Finish Duraflex Partial | Option 2 | 12 | EA | |
| 2054 | RARDUR-PRO Reset After Finish Duraflex-Proc | Option 2 | 12 | EA | |
| 2055 | RAFDUR-WTI Reset After Finish Duraflex-WTI | Option 2 | 10 | EA | |
| 2056 | UDURD Upper Duraflex Denture Complete | Option 2 | 32 | EA | |
| 2057 | UDUR Upper Duraflex Partial Complete | Option 2 | 32 | EA | |
| 2058 | DIMQ Digital Implant Model Quad | Option 2 | 1 | EA | |
| 2059 | DMQ Digital Model Quad | Option 2 | 1 | EA | |
| 2060 | TAP Tap 3 Appliance | Option 2 | 17 | EA | |
| 2061 | LPC Lower Partial Complete | Option 2 | 21 | EA | |
| 2062 | LPF Lower Partial Frame | Option 2 | 48 | EA | |
| 2063 | LVPF Lower Vitallium Partial Frame | Option 2 | 11 | EA | |
| 2064 | UPC Upper partial Complete | Option 2 | 28 | EA | |
| 2065 | UPF Upper Partial Frame | Option 2 | 35 | EA | |
| 2066 | UVPF Upper Vitallium Partial Frame | Option 2 | 16 | EA | |
| 2067 | PV Porcelain Veneer | Option 2 | 11 | EA | |
| 2068 | SRPMMA Scew Retained PMMA Temporary Crown | Option 2 | 12 | EA | |
| 2069 | OFPFM Open Face Crown | Option 2 | 15 | EA | |
| 2070 | CSM Ceramic Space Maintainer | Option 2 | 1 | EA | |
| 2071 | FASM Full Arch Space Maintainer | Option 2 | 1 | EA | |
| 2072 | HR Hawley Retainer | Option 2 | 1 | EA | |
| 2073 | EMA Myerson EMA | Option 2 | 1 | EA | |
| 2074 | NA Nance Appliance | Option 2 | 1 | EA | |
| 2075 | NES Nesbit | Option 2 | 1 | EA | |
| 2076 | LAB Labor | Option 2 | 5 | EA | |
| 2077 | DBB Denture Bite Block | Option 2 | 78 | EA | |
| 2078 | DPMS Duplicate Model and Seat | Option 2 | 63 | EA | |
| 2079 | IAP Immediate Acrylic Partial | Option 2 | 10 | EA | |
| 2080 | ID Immediate Denture | Option 2 | 13 | EA | |
| 2081 | IP Immediate Partial | Option 2 | 5 | EA | |
| 2082 | JD Jump Denture | Option 2 | 5 | EA | |
| 2083 | LAPLC Lower Acrylic Partial Lucitone Process | Option 2 | 25 | EA | |
| 2084 | LAPP Lower Acrylic Partial Process | Option 2 | 13 | EA | |
| 2085 | LAPS Lower Acrylic Partial Setup | Option 2 | 10 | EA | |
| 2086 | LDLP Lower Denture Lucitone Process | Option 2 | 35 | EA | |
| 2087 | LDP Lower Denture Process | Option 2 | 38 | EA | |
| 2088 | LDS Lower Denture Setup | Option 2 | 33 | EA | |
| 2089 | LDPP Lower Duraflex Partial Process | Option 2 | 8 | EA | |
| 2090 | LDPS Lower Duraflex Partial Setup | Option 2 | 5 | EA | |
| 2091 | LPLP Lower Partial Lulcitone Process | Option 2 | 30 | EA | |
| 2092 | LPP Lower Partial Process | Option 2 | 60 | EA | |
| 2093 | LPS Lower Partial Setup | Option 2 | 48 | EA | |
| 2094 | RELL Reline Lucitone | Option 2 | 3 | EA | |
| 2095 | Noble Alloy 61 | Option 2 | 24.5 | EA | |
| 2096 | PT Plastic Tooth | Option 2 | 45 | EA | |
| 2097 | RD Reset Denture | Option 2 | 5 | EA | |
| 2098 | RP Reset Partial | Option 2 | 8 | EA | |
| 2099 | UAPLC Upper Acrylic Partial lucitone Process | Option 2 | 23 | EA | |
| 2100 | UAPP Upper Acrylic partial Process | Option 2 | 20 | EA | |
| 2101 | UAPS Upper Acrylic Partial Setup | Option 2 | 10 | EA | |
| 2102 | UDLP Upper Denture Lucitone Process | Option 2 | 63 | EA | |
| 2103 | UDP Upper Denture Process | Option 2 | 63 | EA | |
| 2104 | UDS Upper Denture Setup | Option 2 | 55 | EA | |
| 2105 | UDPC Upper Duraflex Partial Complete | Option 2 | 20 | EA | |
| 2106 | UDPP Upper Duraflex Partical Process | Option 2 | 8 | EA | |
| 2107 | UDPS Upper Duraflex partial Setup | Option 2 | 5 | EA | |
| 2108 | UPLP Upper Partial Lucitone Process | Option 2 | 23 | EA | |
| 2109 | UPP Upper Partial Process | Option 2 | 33 | EA | |
| 2110 | UPS Upper Partial Process | Option 2 | 25 | EA | |
| 2111 | WP Weld Partial | Option 2 | 5 | EA | |
| 2112 | WWC Wrought Wire Clasp | Option 2 | 138 | EA | |
| 2113 | Yellow Full Cast | Option 2 | 81 | EA | |
| Total Price Option Year Two |
| 3001 | ATLG Atlantis Gold Hue Abutment | Option 3 | 3 | EA | |
| 3002 | ATLT Atlantis Titanium Abutment | Option 3 | 3 | EA | |
| 3003 | ATLZ Atlantis Zirconia Abutment | Option 3 | 3 | EA | |
| 3004 | ENCT Encode Titanium Abutment | Option 3 | 3 | EA | |
| 3005 | NEOTI Neodent Titanium Abutment | Option 3 | 5 | EA | |
| 3006 | NEOZI Neodent Zirconia Abutment | Option 3 | 4 | EA | |
| 3007 | PROT Nobel Procera Titanium Abutment | Option 3 | 4 | EA | |
| 3008 | STRCAD Straumann CadCam Titanium Abutment | Option 3 | 6 | EA | |
| 3009 | STRT Straumann Titanium Abutment | Option 3 | 5 | EA | |
| 3010 | FCZ Brux Full Contour Zirconia | Option 3 | 5 | EA | |
| 3011 | CELT Celtra Crown | Option 3 | 22 | EA | |
| 3012 | CELTI Celtra Inlay | Option 3 | 22 | EA | |
| 3013 | CELTV Celtra Veneer | Option 3 | 15 | EA | |
| 3014 | FCZV Full Contour Zirconia Veneer | Option 3 | 12 | EA | |
| 3015 | EMAX IPS Emax Crown | Option 3 | 12 | EA | |
| 3016 | EMAXV IPS Emax Veneer | Option 3 | 12 | EA | |
| 3017 | LEMAX Layered Emax Crown | Option 3 | 21 | EA | |
| 3018 | PMMA PMMA Temporary Crown | Option 3 | 42 | EA | |
| 3019 | PIO Porcelain Inlay Crown | Option 3 | 31 | EA | |
| 3020 | PFZ Porcelain to Zirconia Crown | Option 3 | 31 | EA | |
| 3021 | DW Diagnostic Waxup | Option 3 | 42 | EA | |
| 3022 | DDWU Digital Diagnostic Waxup | Option 3 | 40 | EA | |
| 3023 | FCC Full Cast Crown | Option 3 | 43 | EA | |
| 3024 | IN/ON Inlay/Onlay | Option 3 | 28 | EA | |
| 3025 | PFM Porcelain Fused to Metal Crown | Option 3 | 40 | EA | |
| 3026 | AF Acrylic Flipper | Option 3 | 30 | EA | |
| 3027 | AMG Athletic Mouth Guard | Option 3 | 5 | EA | |
| 3028 | CT Custom Tray | Option 3 | 33 | EA | |
| 3029 | ESSEX Essex Retainer | Option 3 | 5 | EA | |
| 3030 | HNG Hard Night Guard | Option 3 | 15 | EA | |
| 3031 | HSNG Hard/Soft Night Guard | Option 3 | 12 | EA | |
| 3032 | ISJ Implant Seating Jig | Option 3 | 5 | EA | |
| 3033 | ISG Implant Surgical Group | Option 3 | 16 | EA | |
| 3034 | ISS Implant Surgical Stent | Option 3 | 14 | EA | |
| 3035 | IVJ Implant Verification Jig | Option 3 | 13 | EA | |
| 3036 | LAP Lower Acrylic Partial Complete | Option 3 | 28 | EA | |
| 3037 | LDC Lower Denture Complete | Option 3 | 28 | EA | |
| 3038 | NTI NTI Appliance | Option 3 | 11 | EA | |
| 3039 | PBB Partial Bite Block | Option 3 | 68 | EA | |
| 3040 | REL Reline | Option 3 | 48 | EA | |
| 3041 | REP Repair | Option 3 | 108 | EA | |
| 3042 | SDREL Same Day Reline | Option 3 | 12 | EA | |
| 3043 | SREP Same Day Repair | Option 3 | 12 | EA | |
| 3044 | SNG Soft Night Guard | Option 3 | 18 | EA | |
| 3045 | SREL Soft Reline | Option 3 | 15 | EA | |
| 3046 | UAP Upper Acrylic Partial Complete | Option 3 | 8 | EA | |
| 3047 | UDC Upper Denture Complete | Option 3 | 16 | EA | |
| 3048 | DURC Duraflex Clasp | Option 3 | 5 | EA | |
| 3049 | DN Duraflex Nesbit | Option 3 | 8 | EA | |
| 3050 | JDUR Jump Duraflex | Option 3 | 8 | EA | |
| 3051 | LDURD Lower Duraflex Denture Complete | Option 3 | 16 | EA | |
| 3052 | LDUR Lower Duraflex Partial Complete | Option 3 | 20 | EA | |
| 3053 | RAFDUR Reset After Finish Duraflex Partial | Option 3 | 12 | EA | |
| 3054 | RARDUR-PRO Reset After Finish Duraflex-Proc | Option 3 | 12 | EA | |
| 3055 | RAFDUR-WTI Reset After Finish Duraflex-WTI | Option 3 | 10 | EA | |
| 3056 | UDURD Upper Duraflex Denture Complete | Option 3 | 32 | EA | |
| 3057 | UDUR Upper Duraflex Partial Complete | Option 3 | 32 | EA | |
| 3058 | DIMQ Digital Implant Model Quad | Option 3 | 1 | EA | |
| 3059 | DMQ Digital Model Quad | Option 3 | 1 | EA | |
| 3060 | TAP Tap 3 Appliance | Option 3 | 17 | EA | |
| 3061 | LPC Lower Partial Complete | Option 3 | 21 | EA | |
| 3062 | LPF Lower Partial Frame | Option 3 | 48 | EA | |
| 3063 | LVPF Lower Vitallium Partial Frame | Option 3 | 11 | EA | |
| 3064 | UPC Upper partial Complete | Option 3 | 28 | EA | |
| 3065 | UPF Upper Partial Frame | Option 3 | 35 | EA | |
| 3066 | UVPF Upper Vitallium Partial Frame | Option 3 | 16 | EA | |
| 3067 | PV Porcelain Veneer | Option 3 | 11 | EA | |
| 3068 | SRPMMA Scew Retained PMMA Temporary Crown | Option 3 | 12 | EA | |
| 3069 | OFPFM Open Face Crown | Option 3 | 15 | EA | |
| 3070 | CSM Ceramic Space Maintainer | Option 3 | 1 | EA | |
| 3071 | FASM Full Arch Space Maintainer | Option 3 | 1 | EA | |
| 3072 | HR Hawley Retainer | Option 3 | 1 | EA | |
| 3073 | EMA Myerson EMA | Option 3 | 1 | EA | |
| 3074 | NA Nance Appliance | Option 3 | 1 | EA | |
| 3075 | NES Nesbit | Option 3 | 1 | EA | |
| 3076 | LAB Labor | Option 3 | 5 | EA | |
| 3077 | DBB Denture Bite Block | Option 3 | 78 | EA | |
| 3078 | DPMS Duplicate Model and Seat | Option 3 | 63 | EA | |
| 3079 | IAP Immediate Acrylic Partial | Option 3 | 10 | EA | |
| 3080 | ID Immediate Denture | Option 3 | 13 | EA | |
| 3081 | IP Immediate Partial | Option 3 | 5 | EA | |
| 3082 | JD Jump Denture | Option 3 | 5 | EA | |
| 3083 | LAPLC Lower Acrylic Partial Lucitone Process | Option 3 | 25 | EA | |
| 3084 | LAPP Lower Acrylic Partial Process | Option 3 | 13 | EA | |
| 3085 | LAPS Lower Acrylic Partial Setup | Option 3 | 10 | EA | |
| 3086 | LDLP Lower Denture Lucitone Process | Option 3 | 35 | EA | |
| 3087 | LDP Lower Denture Process | Option 3 | 38 | EA | |
| 3088 | LDS Lower Denture Setup | Option 3 | 33 | EA | |
| 3089 | LDPP Lower Duraflex Partial Process | Option 3 | 8 | EA | |
| 3090 | LDPS Lower Duraflex Partial Setup | Option 3 | 5 | EA | |
| 3091 | LPLP Lower Partial Lulcitone Process | Option 3 | 30 | EA | |
| 3092 | LPP Lower Partial Process | Option 3 | 60 | EA | |
| 3093 | LPS Lower Partial Setup | Option 3 | 48 | EA | |
| 3094 | RELL Reline Lucitone | Option 3 | 3 | EA | |
| 3095 | Noble Alloy 61 | Option 3 | 24.5 | EA | |
| 3096 | PT Plastic Tooth | Option 3 | 45 | EA | |
| 3097 | RD Reset Denture | Option 3 | 5 | EA | |
| 3098 | RP Reset Partial | Option 3 | 8 | EA | |
| 3099 | UAPLC Upper Acrylic Partial lucitone Process | Option 3 | 23 | EA | |
| 3100 | UAPP Upper Acrylic partial Process | Option 3 | 20 | EA | |
| 3101 | UAPS Upper Acrylic Partial Setup | Option 3 | 10 | EA | |
| 3102 | UDLP Upper Denture Lucitone Process | Option 3 | 63 | EA | |
| 3103 | UDP Upper Denture Process | Option 3 | 63 | EA | |
| 3104 | UDS Upper Denture Setup | Option 3 | 55 | EA | |
| 3105 | UDPC Upper Duraflex Partial Complete | Option 3 | 20 | EA | |
| 3106 | UDPP Upper Duraflex Partical Process | Option 3 | 8 | EA | |
| 3107 | UDPS Upper Duraflex partial Setup | Option 3 | 5 | EA | |
| 3108 | UPLP Upper Partial Lucitone Process | Option 3 | 23 | EA | |
| 3109 | UPP Upper Partial Process | Option 3 | 33 | EA | |
| 3110 | UPS Upper Partial Process | Option 3 | 25 | EA | |
| 3111 | WP Weld Partial | Option 3 | 5 | EA | |
| 3112 | WWC Wrought Wire Clasp | Option 3 | 138 | EA | |
| 3113 | Yellow Full Cast | Option 3 | 81 | EA | |
| Total Price Option Year Three |
| 4001 | ATLG Atlantis Gold Hue Abutment | Option 4 | 3 | EA | |
| 4002 | ATLT Atlantis Titanium Abutment | Option 4 | 3 | EA | |
| 4003 | ATLZ Atlantis Zirconia Abutment | Option 4 | 3 | EA | |
| 4004 | ENCT Encode Titanium Abutment | Option 4 | 3 | EA | |
| 4005 | NEOTI Neodent Titanium Abutment | Option 4 | 5 | EA | |
| 4006 | NEOZI Neodent Zirconia Abutment | Option 4 | 4 | EA | |
| 4007 | PROT Nobel Procera Titanium Abutment | Option 4 | 4 | EA | |
| 4008 | STRCAD Straumann CadCam Titanium Abutment | Option 4 | 6 | EA | |
| 4009 | STRT Straumann Titanium Abutment | Option 4 | 5 | EA | |
| 4010 | FCZ Brux Full Contour Zirconia | Option 4 | 5 | EA | |
| 4011 | CELT Celtra Crown | Option 4 | 22 | EA | |
| 4012 | CELTI Celtra Inlay | Option 4 | 22 | EA | |
| 4013 | CELTV Celtra Veneer | Option 4 | 15 | EA | |
| 4014 | FCZV Full Contour Zirconia Veneer | Option 4 | 12 | EA | |
| 4015 | EMAX IPS Emax Crown | Option 4 | 12 | EA | |
| 4016 | EMAXV IPS Emax Veneer | Option 4 | 12 | EA | |
| 4017 | LEMAX Layered Emax Crown | Option 4 | 21 | EA | |
| 4018 | PMMA PMMA Temporary Crown | Option 4 | 42 | EA | |
| 4019 | PIO Porcelain Inlay Crown | Option 4 | 31 | EA | |
| 4020 | PFZ Porcelain to Zirconia Crown | Option 4 | 31 | EA | |
| 4021 | DW Diagnostic Waxup | Option 4 | 42 | EA | |
| 4022 | DDWU Digital Diagnostic Waxup | Option 4 | 40 | EA | |
| 4023 | FCC Full Cast Crown | Option 4 | 43 | EA | |
| 4024 | IN/ON Inlay/Onlay | Option 4 | 28 | EA | |
| 4025 | PFM Porcelain Fused to Metal Crown | Option 4 | 40 | EA | |
| 4026 | AF Acrylic Flipper | Option 4 | 30 | EA | |
| 4027 | AMG Athletic Mouth Guard | Option 4 | 5 | EA | |
| 4028 | CT Custom Tray | Option 4 | 33 | EA | |
| 4029 | ESSEX Essex Retainer | Option 4 | 5 | EA | |
| 4030 | HNG Hard Night Guard | Option 4 | 15 | EA | |
| 4031 | HSNG Hard/Soft Night Guard | Option 4 | 12 | EA | |
| 4032 | ISJ Implant Seating Jig | Option 4 | 5 | EA | |
| 4033 | ISG Implant Surgical Group | Option 4 | 16 | EA | |
| 4034 | ISS Implant Surgical Stent | Option 4 | 14 | EA | |
| 4035 | IVJ Implant Verification Jig | Option 4 | 13 | EA | |
| 4036 | LAP Lower Acrylic Partial Complete | Option 4 | 28 | EA | |
| 4037 | LDC Lower Denture Complete | Option 4 | 28 | EA | |
| 4038 | NTI NTI Appliance | Option 4 | 11 | EA | |
| 4039 | PBB Partial Bite Block | Option 4 | 68 | EA | |
| 4040 | REL Reline | Option 4 | 48 | EA | |
| 4041 | REP Repair | Option 4 | 108 | EA | |
| 4042 | SDREL Same Day Reline | Option 4 | 12 | EA | |
| 4043 | SREP Same Day Repair | Option 4 | 12 | EA | |
| 4044 | SNG Soft Night Guard | Option 4 | 18 | EA | |
| 4045 | SREL Soft Reline | Option 4 | 15 | EA | |
| 4046 | UAP Upper Acrylic Partial Complete | Option 4 | 8 | EA | |
| 4047 | UDC Upper Denture Complete | Option 4 | 16 | EA | |
| 4048 | DURC Duraflex Clasp | Option 4 | 5 | EA | |
| 4049 | DN Duraflex Nesbit | Option 4 | 8 | EA | |
| 4050 | JDUR Jump Duraflex | Option 4 | 8 | EA | |
| 4051 | LDURD Lower Duraflex Denture Complete | Option 4 | 16 | EA | |
| 4052 | LDUR Lower Duraflex Partial Complete | Option 4 | 20 | EA | |
| 4053 | RAFDUR Reset After Finish Duraflex Partial | Option 4 | 12 | EA | |
| 4054 | RARDUR-PRO Reset After Finish Duraflex-Proc | Option 4 | 12 | EA | |
| 4055 | RAFDUR-WTI Reset After Finish Duraflex-WTI | Option 4 | 10 | EA | |
| 4056 | UDURD Upper Duraflex Denture Complete | Option 4 | 32 | EA | |
| 4057 | UDUR Upper Duraflex Partial Complete | Option 4 | 32 | EA | |
| 4058 | DIMQ Digital Implant Model Quad | Option 4 | 1 | EA | |
| 4059 | DMQ Digital Model Quad | Option 4 | 1 | EA | |
| 4060 | TAP Tap 3 Appliance | Option 4 | 17 | EA | |
| 4061 | LPC Lower Partial Complete | Option 4 | 21 | EA | |
| 4062 | LPF Lower Partial Frame | Option 4 | 48 | EA | |
| 4063 | LVPF Lower Vitallium Partial Frame | Option 4 | 11 | EA | |
| 4064 | UPC Upper partial Complete | Option 4 | 28 | EA | |
| 4065 | UPF Upper Partial Frame | Option 4 | 35 | EA | |
| 4066 | UVPF Upper Vitallium Partial Frame | Option 4 | 16 | EA | |
| 4067 | PV Porcelain Veneer | Option 4 | 11 | EA | |
| 4068 | SRPMMA Scew Retained PMMA Temporary Crown | Option 4 | 12 | EA | |
| 4069 | OFPFM Open Face Crown | Option 4 | 15 | EA | |
| 4070 | CSM Ceramic Space Maintainer | Option 4 | 1 | EA | |
| 4071 | FASM Full Arch Space Maintainer | Option 4 | 1 | EA | |
| 4072 | HR Hawley Retainer | Option 4 | 1 | EA | |
| 4073 | EMA Myerson EMA | Option 4 | 1 | EA | |
| 4074 | NA Nance Appliance | Option 4 | 1 | EA | |
| 4075 | NES Nesbit | Option 4 | 1 | EA | |
| 4076 | LAB Labor | Option 4 | 5 | EA | |
| 4077 | DBB Denture Bite Block | Option 4 | 78 | EA | |
| 4078 | DPMS Duplicate Model and Seat | Option 4 | 63 | EA | |
| 4079 | IAP Immediate Acrylic Partial | Option 4 | 10 | EA | |
| 4080 | ID Immediate Denture | Option 4 | 13 | EA | |
| 4081 | IP Immediate Partial | Option 4 | 5 | EA | |
| 4082 | JD Jump Denture | Option 4 | 5 | EA | |
| 4083 | LAPLC Lower Acrylic Partial Lucitone Process | Option 4 | 25 | EA | |
| 4084 | LAPP Lower Acrylic Partial Process | Option 4 | 13 | EA | |
| 4085 | LAPS Lower Acrylic Partial Setup | Option 4 | 10 | EA | |
| 4086 | LDLP Lower Denture Lucitone Process | Option 4 | 35 | EA | |
| 4087 | LDP Lower Denture Process | Option 4 | 38 | EA | |
| 4088 | LDS Lower Denture Setup | Option 4 | 33 | EA | |
| 4089 | LDPP Lower Duraflex Partial Process | Option 4 | 8 | EA | |
| 4090 | LDPS Lower Duraflex Partial Setup | Option 4 | 5 | EA | |
| 4091 | LPLP Lower Partial Lulcitone Process | Option 4 | 30 | EA | |
| 4092 | LPP Lower Partial Process | Option 4 | 60 | EA | |
| 4093 | LPS Lower Partial Setup | Option 4 | 48 | EA | |
| 4094 | RELL Reline Lucitone | Option 4 | 3 | EA | |
| 4095 | Noble Alloy 61 | Option 4 | 24.5 | EA | |
| 4096 | PT Plastic Tooth | Option 4 | 45 | EA | |
| 4097 | RD Reset Denture | Option 4 | 5 | EA | |
| 4098 | RP Reset Partial | Option 4 | 8 | EA | |
| 4099 | UAPLC Upper Acrylic Partial lucitone Process | Option 4 | 23 | EA | |
| 4100 | UAPP Upper Acrylic partial Process | Option 4 | 20 | EA | |
| 4101 | UAPS Upper Acrylic Partial Setup | Option 4 | 10 | EA | |
| 4102 | UDLP Upper Denture Lucitone Process | Option 4 | 63 | EA | |
| 4103 | UDP Upper Denture Process | Option 4 | 63 | EA | |
| 4104 | UDS Upper Denture Setup | Option 4 | 55 | EA | |
| 4105 | UDPC Upper Duraflex Partial Complete | Option 4 | 20 | EA | |
| 4106 | UDPP Upper Duraflex Partical Process | Option 4 | 8 | EA | |
| 4107 | UDPS Upper Duraflex partial Setup | Option 4 | 5 | EA | |
| 4108 | UPLP Upper Partial Lucitone Process | Option 4 | 23 | EA | |
| 4109 | UPP Upper Partial Process | Option 4 | 33 | EA | |
| 4110 | UPS Upper Partial Process | Option 4 | 25 | EA | |
| 4111 | WP Weld Partial | Option 4 | 5 | EA | |
| 4112 | WWC Wrought Wire Clasp | Option 4 | 138 | EA | |
| 4113 | Yellow Full Cast | Option 4 | 81 | EA | |
| Total Price Option Year 4 |
File details come from the government source that posted it. Updated .