S02 Pricing Schedule.xlsx

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VA San Francisco Dental Lab Prostheses Supplies and Related Services
Solicitation number
36C26127Q0022
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This is a Pricing Schedule for Solicitation 36C26127Q0022 for dental laboratory prostheses and related services to support the VA San Francisco Health Care System. The schedule outlines line items for various dental lab services with associated quantities for the base year and four option years, including fixed prostheses (crowns, bridges), removable prostheses (dentures, partials), implant-related services, and specialized items such as 3D printed models and custom abutments. Each line item specifies a quantity requirement across the base year and four one-year option periods, with pricing columns left blank for contractor completion. The pricing schedule includes over 1,000 line items covering a comprehensive range of dental laboratory work, from simple procedures like tooth additions to complex prostheses using various materials including precious metals (gold, palladium, silver) and specialized alloys. Contractors are required to submit unit prices for each item in the base year and option year periods to establish the pricing structure for this requirements-based contract supporting dental services at two VA locations in California: the primary facility in San Francisco and the South Santa Rosa clinic.

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Price Schedule

Solicitation 36C26127Q0022 Pricing Schedule for Dental Lab
Item #Description/Part NumberQtyBase YearBase Year TotalOption Year 1Option Year 1 TotalOption Year 2Option Year 2 TotalOption Year 3Option Year 3 TotalOption Year 4Option Year 4 Total
10013/4 Gold Crown (Plus Metal)20$ - 0$ - 0$ - 0$ - 0$ - 0
10023D Printed Model 1/2 Set - Full Arch10$ - 0$ - 0$ - 0$ - 0$ - 0
10033D Printed Model Set - CB60$ - 0$ - 0$ - 0$ - 0$ - 0
10043D Printed Model Set - Full Arch30$ - 0$ - 0$ - 0$ - 0$ - 0
1007Acrylic Denture 1-3 Teeth10$ - 0$ - 0$ - 0$ - 0$ - 0
1008Acrylic Denture 4-8 Teeth10$ - 0$ - 0$ - 0$ - 0$ - 0
1009Acrylic Denture 9-14 Teeth10$ - 0$ - 0$ - 0$ - 0$ - 0
1010Adapt Crown to Partial5$ - 0$ - 0$ - 0$ - 0$ - 0
1011Add Tooth Denture/Partial (30 day guarantee)15$ - 0$ - 0$ - 0$ - 0$ - 0
1012Additional OEM Custom Abutments50$ - 0$ - 0$ - 0$ - 0$ - 0
1013Altered Cast3$ - 0$ - 0$ - 0$ - 0$ - 0
1018Argedent Euro* (PFM; Au 40, Pd 39.4; Ag 10)200$ - 0$ - 0$ - 0$ - 0$ - 0
1019Argelite 71* (PFM; Pd 70.9; Ag 10; In 8; Sn 5.3; Zn 5; Ga <1; Ru <1)10$ - 0$ - 0$ - 0$ - 0$ - 0
1020Argen Titanium Abutment10$ - 0$ - 0$ - 0$ - 0$ - 0
1021Argen Zirconia Abutment2$ - 0$ - 0$ - 0$ - 0$ - 0
1022Argenco 40* (FGC; Au 40; Ag 45.7; Zn 1; Pd 4.95; Cu 8.3)75$ - 0$ - 0$ - 0$ - 0$ - 0
1023Argenco 40Y* (FGC; Ag 45.99; Au 39.9; Cu 7.59; Pd 4; In 1.5; Zn 1; Ir <1; Li <1)75$ - 0$ - 0$ - 0$ - 0$ - 0
1024Argenco 58* ( FGC; Au58; Pd 3.25; A6 27; Cu 10.49; Zn 1; Ir <1; In <1)75$ - 0$ - 0$ - 0$ - 0$ - 0
1025Argenco Au2* (FGC; Au 2; Pd 32.7; Ag 34.5; In 28; Zn 2.6; Ir <1)5$ - 0$ - 0$ - 0$ - 0$ - 0
1026Argendent Y73* (PFM; Au 73.8; Pt 8.5; Pd 5.4; Ag 8.98; In 1.9; Nb75$ - 0$ - 0$ - 0$ - 0$ - 0
1033Astroflex Nightguard Traditional75$ - 0$ - 0$ - 0$ - 0$ - 0
1034Atlantis GoldHue Abutment5$ - 0$ - 0$ - 0$ - 0$ - 0
1035Atlantis Titanium Abutment5$ - 0$ - 0$ - 0$ - 0$ - 0
1036Atlantis Zirconia Abutment2$ - 0$ - 0$ - 0$ - 0$ - 0
1037Attachment Labor5$ - 0$ - 0$ - 0$ - 0$ - 0
1038Attachment Processing Fee5$ - 0$ - 0$ - 0$ - 0$ - 0
1042Bleaching Splint20$ - 0$ - 0$ - 0$ - 0$ - 0
1043Bone Modeling Fee5$ - 0$ - 0$ - 0$ - 0$ - 0
1044Cad/cam 2 in 1 overdenture 4 implants Titanium/Acrylic1$ - 0$ - 0$ - 0$ - 0$ - 0
1045Cad/cam 2 in 1 overdenture 5 implants Titanium/Acrylic1$ - 0$ - 0$ - 0$ - 0$ - 0
1046Cad/cam 2 in 1 overdenture 6 implants Titanium/Acrylic1$ - 0$ - 0$ - 0$ - 0$ - 0
1047Cad/Cam Hybrid Denture 4 implants Titanium/Acrylic1$ - 0$ - 0$ - 0$ - 0$ - 0
1048Cad/Cam Hybrid Denture 5 implants Titanium/Acrylic1$ - 0$ - 0$ - 0$ - 0$ - 0
1049Cad/Cam Hybrid Denture 6 implants Titanium/Acrylic1$ - 0$ - 0$ - 0$ - 0$ - 0
1050Cad/cam screw retained zirconia superstructure 4 implants Including PMMA prototype1$ - 0$ - 0$ - 0$ - 0$ - 0
1051Cad/cam screw retained zirconia superstructure 4 implants Nobel Including PMMA prototype1$ - 0$ - 0$ - 0$ - 0$ - 0
1052Cad/cam screw retained zirconia superstructure 5 implants Including PMMA prototype1$ - 0$ - 0$ - 0$ - 0$ - 0
1053Cad/cam screw retained zirconia superstructure 5 implants Nobel Including PMMA prototype1$ - 0$ - 0$ - 0$ - 0$ - 0
1054Cad/cam screw retained zirconia superstructure 6 implants Including PMMA prototype1$ - 0$ - 0$ - 0$ - 0$ - 0
1055Cad/cam screw retained zirconia superstructure 6 implants Nobel Including PMMA prototype1$ - 0$ - 0$ - 0$ - 0$ - 0
1056Cad/cam Zirconia Hybrid Superstructure on Milled Titanium Bar Substructure 4 Implants Including PMMA prototype1$ - 0$ - 0$ - 0$ - 0$ - 0
1057Cad/cam Zirconia Hybrid Superstructure on Milled Titanium Bar Substructure 5 Implants Including PMMA prototype1$ - 0$ - 0$ - 0$ - 0$ - 0
1058Cad/cam Zirconia Hybrid Superstructure on Milled Titanium Bar Substructure 6 Implants Including PMMA prototype1$ - 0$ - 0$ - 0$ - 0$ - 0
1059Case Setup and Treatment Planning Only- No Guide Fabricated8$ - 0$ - 0$ - 0$ - 0$ - 0
1060Cast Clasp New Denture5$ - 0$ - 0$ - 0$ - 0$ - 0
1061Cast Repair (30 day guarantee)5$ - 0$ - 0$ - 0$ - 0$ - 0
1062Cast, Post & Core (Plus Metal)10$ - 0$ - 0$ - 0$ - 0$ - 0
1065Clear Splint10$ - 0$ - 0$ - 0$ - 0$ - 0
1066Complex Acrylic Repair (30 day guarantee)10$ - 0$ - 0$ - 0$ - 0$ - 0
1068Composite Crown5$ - 0$ - 0$ - 0$ - 0$ - 0
1069Composite Inlay/Onlay3$ - 0$ - 0$ - 0$ - 0$ - 0
1076Crown/Abutment Cementation200$ - 0$ - 0$ - 0$ - 0$ - 0
1077Custom Abutment (Wax/Cast Labor)10$ - 0$ - 0$ - 0$ - 0$ - 0
1078Custom Shaded Acrylic Flange1$ - 0$ - 0$ - 0$ - 0$ - 0
1079Custom Shading15$ - 0$ - 0$ - 0$ - 0$ - 0
1080Denture Bite Rim15$ - 0$ - 0$ - 0$ - 0$ - 0
1081Denture Custom Tray15$ - 0$ - 0$ - 0$ - 0$ - 0
1083Design Crown for Partial30$ - 0$ - 0$ - 0$ - 0$ - 0
1084Design Partial1$ - 0$ - 0$ - 0$ - 0$ - 0
1085Diagnostic Wax-up (per tooth)200$ - 0$ - 0$ - 0$ - 0$ - 0
1089Dual Laminate Nightguard10$ - 0$ - 0$ - 0$ - 0$ - 0
1090Duplicate Denture5$ - 0$ - 0$ - 0$ - 0$ - 0
1091Duplicate Model10$ - 0$ - 0$ - 0$ - 0$ - 0
1092e.max Crown (Posterior)15$ - 0$ - 0$ - 0$ - 0$ - 0
1093e.max Crown/Veneer (Anterior)35$ - 0$ - 0$ - 0$ - 0$ - 0
1094e.max Inlay/Onlay10$ - 0$ - 0$ - 0$ - 0$ - 0
1095e.max to Implant (Anterior)5$ - 0$ - 0$ - 0$ - 0$ - 0
1096e.max to Implant Cemented3$ - 0$ - 0$ - 0$ - 0$ - 0
1097e.max to Implant Screw Retained3$ - 0$ - 0$ - 0$ - 0$ - 0
1105Essix Appliance10$ - 0$ - 0$ - 0$ - 0$ - 0
1106F/F Cast Base5$ - 0$ - 0$ - 0$ - 0$ - 0
1107Finish Teeth on New P/P 1-3 Teeth15$ - 0$ - 0$ - 0$ - 0$ - 0
1108Finish Teeth on New P/P 4-8 Teeth15$ - 0$ - 0$ - 0$ - 0$ - 0
1109Finish Teeth on New P/P 9-14 Teeth15$ - 0$ - 0$ - 0$ - 0$ - 0
1110Fixed Prosthetic Laser Weld3$ - 0$ - 0$ - 0$ - 0$ - 0
1111Flexible Clasp6$ - 0$ - 0$ - 0$ - 0$ - 0
1112Flexible Partial Finish 1-3 Teeth8$ - 0$ - 0$ - 0$ - 0$ - 0
1113Flexible Partial Finish 4-8 Teeth5$ - 0$ - 0$ - 0$ - 0$ - 0
1114Flexible Partial Finish 9-14 Teeth5$ - 0$ - 0$ - 0$ - 0$ - 0
1115Flexible Partial Set 1-3 Teeth8$ - 0$ - 0$ - 0$ - 0$ - 0
1116Flexible Partial Set 4-8 Teeth5$ - 0$ - 0$ - 0$ - 0$ - 0
1117Flexible Partial Set 9-14 Teeth5$ - 0$ - 0$ - 0$ - 0$ - 0
1120Full Denture Setup20$ - 0$ - 0$ - 0$ - 0$ - 0
1121Full Denture Shade Change5$ - 0$ - 0$ - 0$ - 0$ - 0
1122Full Gold Crown (Plus Metal)140$ - 0$ - 0$ - 0$ - 0$ - 0
1123Full Gold Crown to Implant Cemented (Plus Metal)2$ - 0$ - 0$ - 0$ - 0$ - 0
1124Full Gold Crown to Implant Screw Retained (Plus Metal)2$ - 0$ - 0$ - 0$ - 0$ - 0
1125Fully Guided Stackable Surgical Guide with Bone Reduction Guides5$ - 0$ - 0$ - 0$ - 0$ - 0
1126Fully Guided Surgical Guide Base Fee5$ - 0$ - 0$ - 0$ - 0$ - 0
1132Gold Inlay/Onlay (Plus Metal)5$ - 0$ - 0$ - 0$ - 0$ - 0
1134Hader/EDS Clip Gold6$ - 0$ - 0$ - 0$ - 0$ - 0
1135Hader/EDS Clip Plastic4$ - 0$ - 0$ - 0$ - 0$ - 0
1136Hader/EDS Housing10$ - 0$ - 0$ - 0$ - 0$ - 0
1138Hard Acrylic Reline20$ - 0$ - 0$ - 0$ - 0$ - 0
1139Hard Nightguard Traditional25$ - 0$ - 0$ - 0$ - 0$ - 0
1140Hard Printed Nightguard25$ - 0$ - 0$ - 0$ - 0$ - 0
1141Hard Printed Nightguard from Scan25$ - 0$ - 0$ - 0$ - 0$ - 0
1142Hard/Soft Printed Nightguard10$ - 0$ - 0$ - 0$ - 0$ - 0
1143Hard/Soft Printed Nightguard from Scan10$ - 0$ - 0$ - 0$ - 0$ - 0
1144Hawley Retainer6$ - 0$ - 0$ - 0$ - 0$ - 0
1147Heraeus Kulzer Artic Anterior Set3$ - 0$ - 0$ - 0$ - 0$ - 0
1148Heraeus Kulzer Artic per Tooth3$ - 0$ - 0$ - 0$ - 0$ - 0
1149Heraeus Kulzer Artic Posterior Set3$ - 0$ - 0$ - 0$ - 0$ - 0
1152Hiossen Titanium Abutment2$ - 0$ - 0$ - 0$ - 0$ - 0
1153Immediate per Arch5$ - 0$ - 0$ - 0$ - 0$ - 0
1154Implant Custom Tray2$ - 0$ - 0$ - 0$ - 0$ - 0
1159Implant Temporary PMMA Crown5$ - 0$ - 0$ - 0$ - 0$ - 0
1160Implant Temporary PMMA Crown Screw Retained20$ - 0$ - 0$ - 0$ - 0$ - 0
1161Implant Verification Jig10$ - 0$ - 0$ - 0$ - 0$ - 0
1162Ivoclar/Phonares Anterior10$ - 0$ - 0$ - 0$ - 0$ - 0
1163Ivoclar/Phonares Posterior10$ - 0$ - 0$ - 0$ - 0$ - 0
1164Ivoclar/Vivadent Anterior Set10$ - 0$ - 0$ - 0$ - 0$ - 0
1165Ivoclar/Vivadent per Tooth10$ - 0$ - 0$ - 0$ - 0$ - 0
1166Ivoclar/Vivadent Plastic Anterior Set (PE)10$ - 0$ - 0$ - 0$ - 0$ - 0
1167Ivoclar/Vivadent Plastic per Tooth (Non PE)10$ - 0$ - 0$ - 0$ - 0$ - 0
1168Ivoclar/Vivadent Plastic Posterior Set (PE)10$ - 0$ - 0$ - 0$ - 0$ - 0
1169Ivoclar/Vivadent Posterior Set10$ - 0$ - 0$ - 0$ - 0$ - 0
1170JelBios 10* (PFM; Au 86.2; Pt 11.5; Zn 1.5; Mn <1; Ru <1; Ta <1)3$ - 0$ - 0$ - 0$ - 0$ - 0
1171Kenson Basic per Tooth2$ - 0$ - 0$ - 0$ - 0$ - 0
1172Kenson Basic Posterior Set2$ - 0$ - 0$ - 0$ - 0$ - 0
1177Ledged Lingual10$ - 0$ - 0$ - 0$ - 0$ - 0
1178Lithium Disilicate Crown (Posterior)15$ - 0$ - 0$ - 0$ - 0$ - 0
1179Lithium Disilicate Crown/Veneer (Anterior)20$ - 0$ - 0$ - 0$ - 0$ - 0
1180Lithium Disilicate Inlay/Onlay10$ - 0$ - 0$ - 0$ - 0$ - 0
1181Lithium Disilicate to Implant (Anterior)3$ - 0$ - 0$ - 0$ - 0$ - 0
1182Lithium Disilicate to Implant Cemented3$ - 0$ - 0$ - 0$ - 0$ - 0
1183Lithium Disilicate to Implant Screw Retained5$ - 0$ - 0$ - 0$ - 0$ - 0
1188Locator Overdenture (*)2$ - 0$ - 0$ - 0$ - 0$ - 0
1189Locator Overdenture on 4 Implants Complete2$ - 0$ - 0$ - 0$ - 0$ - 0
1196Maryland Bridge (1 pontic)6$ - 0$ - 0$ - 0$ - 0$ - 0
1197Maryland Bridge (2 pontics)2$ - 0$ - 0$ - 0$ - 0$ - 0
1198Metal Rest15$ - 0$ - 0$ - 0$ - 0$ - 0
1199Milled Denture Finish3$ - 0$ - 0$ - 0$ - 0$ - 0
1201Milled Denture immediate2$ - 0$ - 0$ - 0$ - 0$ - 0
1202Milled Denture Process Only2$ - 0$ - 0$ - 0$ - 0$ - 0
1203Milled Denture Setup2$ - 0$ - 0$ - 0$ - 0$ - 0
1204Milled Hader Bar/Acrylic Denture on 4 implants1$ - 0$ - 0$ - 0$ - 0$ - 0
1205Milled Hader Bar/Acrylic Denture on 5 Implants1$ - 0$ - 0$ - 0$ - 0$ - 0
1206Milled Hader Bar/Acrylic Denture on 6 Implants1$ - 0$ - 0$ - 0$ - 0$ - 0
1208Nobel Titanium Abutment15$ - 0$ - 0$ - 0$ - 0$ - 0
1209Nobel Zirconia Abutment15$ - 0$ - 0$ - 0$ - 0$ - 0
1210Obturator Bar and Clip Obturator Dental 2 Implants2$ - 0$ - 0$ - 0$ - 0$ - 0
1211Obturator Bar and Clip Obturator Dental Additonal Implants2$ - 0$ - 0$ - 0$ - 0$ - 0
1212Obturator Implant Supported Dental2$ - 0$ - 0$ - 0$ - 0$ - 0
1213Obturator Implant Supported Dental Additonal Implants2$ - 0$ - 0$ - 0$ - 0$ - 0
1215Obturator Palatal Design including wire clasp4$ - 0$ - 0$ - 0$ - 0$ - 0
1217Overdenture Finish2$ - 0$ - 0$ - 0$ - 0$ - 0
1218Partial Conversion to Denture3$ - 0$ - 0$ - 0$ - 0$ - 0
1219Partial Denture Shade Change2$ - 0$ - 0$ - 0$ - 0$ - 0
1220Partial Frame50$ - 0$ - 0$ - 0$ - 0$ - 0
1221Patient ID15$ - 0$ - 0$ - 0$ - 0$ - 0
1222Periodontal Splint2$ - 0$ - 0$ - 0$ - 0$ - 0
1223PFM (12 or more units) (Plus Metal)5$ - 0$ - 0$ - 0$ - 0$ - 0
1224PFM (non-precious alloy included)5$ - 0$ - 0$ - 0$ - 0$ - 0
1225PFM (Plus Metal)4$ - 0$ - 0$ - 0$ - 0$ - 0
1226PFM Bridge (5 units or less) (Plus Metal)16$ - 0$ - 0$ - 0$ - 0$ - 0
1227PFM Bridge (6 units or more) (Plus Metal)10$ - 0$ - 0$ - 0$ - 0$ - 0
1229PFM to Implant Cemented (Plus Metal)5$ - 0$ - 0$ - 0$ - 0$ - 0
1230PFM to Implant Cemented-Metal Occlusal (Plus Metal)1$ - 0$ - 0$ - 0$ - 0$ - 0
1231PFM to Implant Screw Retained (Plus Metal)5$ - 0$ - 0$ - 0$ - 0$ - 0
1232PFM-Metal Occlusal (Plus Metal)12$ - 0$ - 0$ - 0$ - 0$ - 0
1233PGP Gold Clasp (Plus Metal)1$ - 0$ - 0$ - 0$ - 0$ - 0
1234Photogrammetry Service2$ - 0$ - 0$ - 0$ - 0$ - 0
1235Pink Porcelain (per tooth)15$ - 0$ - 0$ - 0$ - 0$ - 0
1236Platinum Plus* (PFM; Pt 20; Co 43.5; Mn <1; Ru 5.7; Cr 29.3; Si <1)2$ - 0$ - 0$ - 0$ - 0$ - 0
1237Porcelain Application Only5$ - 0$ - 0$ - 0$ - 0$ - 0
1238Porcelain Butt Margain2$ - 0$ - 0$ - 0$ - 0$ - 0
1239Porcelain Butt Margin 3602$ - 0$ - 0$ - 0$ - 0$ - 0
1241Pour, Mount & Return5$ - 0$ - 0$ - 0$ - 0$ - 0
1243Prep Abutment3$ - 0$ - 0$ - 0$ - 0$ - 0
1244Printed Denture 1-3 Teeth2$ - 0$ - 0$ - 0$ - 0$ - 0
1245Printed Denture 4-8 Teeth2$ - 0$ - 0$ - 0$ - 0$ - 0
1246Printed Denture 9-14 Teeth2$ - 0$ - 0$ - 0$ - 0$ - 0
1247Printed Denture Finish2$ - 0$ - 0$ - 0$ - 0$ - 0
1248Printed Denture Immediate2$ - 0$ - 0$ - 0$ - 0$ - 0
1249Printed Denture Setup2$ - 0$ - 0$ - 0$ - 0$ - 0
1250Rebase (Jump)15$ - 0$ - 0$ - 0$ - 0$ - 0
1251Reduction Coping Plastic10$ - 0$ - 0$ - 0$ - 0$ - 0
1252Reinforcing Wire/Bar Permanent10$ - 0$ - 0$ - 0$ - 0$ - 0
1253Removeable Prosthetic Laser Weld3$ - 0$ - 0$ - 0$ - 0$ - 0
1258Rest Seat20$ - 0$ - 0$ - 0$ - 0$ - 0
1264Scan/Design10$ - 0$ - 0$ - 0$ - 0$ - 0
1266Set Teeth on New P/P 1-3 Teeth10$ - 0$ - 0$ - 0$ - 0$ - 0
1267Set Teeth on New P/P 4-8 Teeth10$ - 0$ - 0$ - 0$ - 0$ - 0
1268Set Teeth on New P/P 9-14 Teeth10$ - 0$ - 0$ - 0$ - 0$ - 0
1271Simple Acrylic Repair (30 day guarantee)10$ - 0$ - 0$ - 0$ - 0$ - 0
1273Soft Lining3$ - 0$ - 0$ - 0$ - 0$ - 0
1274Soft Nightguard15$ - 0$ - 0$ - 0$ - 0$ - 0
1275Soft Reline5$ - 0$ - 0$ - 0$ - 0$ - 0
1276Soft Tissue Model100$ - 0$ - 0$ - 0$ - 0$ - 0
1278Splinted Joint20$ - 0$ - 0$ - 0$ - 0$ - 0
1279Sportguard3$ - 0$ - 0$ - 0$ - 0$ - 0
1281Straumann Titanium Abutment5$ - 0$ - 0$ - 0$ - 0$ - 0
1282Straumann Zirconia Abutment2$ - 0$ - 0$ - 0$ - 0$ - 0
1283Study Model30$ - 0$ - 0$ - 0$ - 0$ - 0
1284Surgical guide additional implant site20$ - 0$ - 0$ - 0$ - 0$ - 0
1286Surgical Stent/Guide10$ - 0$ - 0$ - 0$ - 0$ - 0
1288Temporary PMMA Crown50$ - 0$ - 0$ - 0$ - 0$ - 0
1289Temporary Splint10$ - 0$ - 0$ - 0$ - 0$ - 0
1293TruAbutment GoldHue Abutment2$ - 0$ - 0$ - 0$ - 0$ - 0
1294TruAbutment Titanium Abutment2$ - 0$ - 0$ - 0$ - 0$ - 0
1295Trubyte Portrait IPN Anterior Set2$ - 0$ - 0$ - 0$ - 0$ - 0
1296Trubyte Portrait IPN Posterior Set2$ - 0$ - 0$ - 0$ - 0$ - 0
1297Unilateral Partial Complete3$ - 0$ - 0$ - 0$ - 0$ - 0
1299Vita Plastic/Porcelain Anterior Set3$ - 0$ - 0$ - 0$ - 0$ - 0
1300Vita Plastic/Porcelain per Tooth3$ - 0$ - 0$ - 0$ - 0$ - 0
1301Vita Plastic/Porcelain Posterior Set3$ - 0$ - 0$ - 0$ - 0$ - 0
1308Wire in Tooth2$ - 0$ - 0$ - 0$ - 0$ - 0
1309Wire/Ball Clasp15$ - 0$ - 0$ - 0$ - 0$ - 0
1310Zimmer Titanium Abutment1$ - 0$ - 0$ - 0$ - 0$ - 0
1311Zimmer Zirconia Abutment1$ - 0$ - 0$ - 0$ - 0$ - 0
1312Zirconia Coping1$ - 0$ - 0$ - 0$ - 0$ - 0
1313Zirconia+ Full Contour Crown (Anterior)25$ - 0$ - 0$ - 0$ - 0$ - 0
1314Zirconia+ Full Contour Crown (Posterior)50$ - 0$ - 0$ - 0$ - 0$ - 0
1315Zirconia+ Full Contour Imp Crown (Anterior)10$ - 0$ - 0$ - 0$ - 0$ - 0
1316Zirconia+ Full Contour Imp Crown (Posterior)60$ - 0$ - 0$ - 0$ - 0$ - 0
1317Zirconia+ Layered Crown (Anterior)20$ - 0$ - 0$ - 0$ - 0$ - 0
1318Zirconia+ Layered Crown (Posterior)5$ - 0$ - 0$ - 0$ - 0$ - 0
1319Zirconia+ Layered Implant Crown (Anterior)10$ - 0$ - 0$ - 0$ - 0$ - 0
1320Zirconia+ Layered Implant Crown (Posterior)3$ - 0$ - 0$ - 0$ - 0$ - 0
$ - 0$ - 0$ - 0$ - 0$ - 0

Base Year Period of Performance: 101/1/2026-9/30/2027

File details come from the government source that posted it. Updated .