Dental_Care_Pricing_Spreadsheet_28_Oct_14.xlsx
XLSX spreadsheet 12 KB Posted
- Attached to
- Dental Restorative Care
- Solicitation number
- W91364-14-R-0024
About this file
Dental Care Pricing Spreadsheet Revised 28 Oct 14
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Other files
| File | Type | Posted |
|---|---|---|
| PWS_04_Nov_14.docx | DOCX document | |
| Admin_QA_04_Nov_14.docx | DOCX document | |
| Technical_QA_04_Nov_14.doc | DOC document | |
| Basis_for_Award.docx | DOCX document | |
| Dental_PWS_01_Oct_14.docx | DOCX document | |
| PP_Evaluation.docx | DOCX document | |
| Evaluation_Criteria.docx | DOCX document | |
| Dental_Care_Pricing_Spreadsheet.xlsx | XLSX spreadsheet | |
| Synopsis-Solicitation_W91364-14-R-0024.docx | DOCX document |
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Text version
Sheet1 Cost for Services
Services 2015 2016
Contractor Manpower Reporting Requirements
| Diagnostic | D0120 Periodic Oral Evaluation |
| D0150 Comprehensive Oral Evaluation | |
| D0272 Bitewings--2 Films | |
| D0274 Bitewings--4 Films | |
| D0330 Panoramic Xray | |
| D0220/D0230 Periapical (limited) |
| Treatment/ Restorative Services | D2140 Amalgam--One Surface |
| D2150 Amalgam--Two Surfaces | |
| D2160 Amalgam--Three Surfaces | |
| D2161 Amalgam--Four or More Surfaces | |
| D2330 Composite--Ons Surface | |
| D2331 Composite--Two Surfaces | |
| D2332 Composite--Three Surfaces | |
| D2335 Composite--Four or More Surfaces | |
| D2390 Resin-Based Composite Crown Anterior | |
| D2391 Composite--Ons Surface | |
| D2392 Composite--Two Surfaces | |
| D2393 Composite--Three Surfaces | |
| D2394 Composite--Four or More Surfaces | |
| D2799 Provisional Crown | |
| D2920 Re-Cement Crown | |
| D2931 Prefabricated Stainless Steel Crown | |
| D2950 Core Buildup, including any pins | |
| D2954 Prefabricated Post and Core |
| Endodontic Services | D3310 Anterior Root Canal Therapy |
| D3320 Bicuspid Root Canal Therapy | |
| D3330 Molar Root Canal Therapy | |
| D3346 Anterior Root Canal Retreatment | |
| D3347 Bicuspid Root Canal Retreatment | |
| D3348 Molar Root Canal Retreatment |
| Periodontal Services | D4355 Full Mouth Debridement |
| D4342 Periodontal Scaling and Root Planing, 1-3 teeth per quadrant |
| Prosthodontic Services | D5110 Complete Denture--Maxillary |
| D5120 Complete Denture--Mandibular | |
| D5211 Maxillary Partial Denture--Resin Base | |
| D5212 Mandibular Partial Denture--Resin Base |
| Oral Surgery Services | D7140 Extraaction, Erupted Tooth or Exposed Root |
| D7210 Surgical Removal of Erupted Tooth | |
| D7220 Removal of Impacted Tooth, Soft Tissue | |
| D7230 Removal of Impacted Tooth, Partial Bony | |
| D7240 Removal of Impacted Tooth, Completely Bony | |
| D7250 Removal of Residual Tooth Roots | |
| D7286 Biopsy of Oral Tissue |
Orthodontic Services D8680 Orthodontic Retention
Event Pricing--includes Management, Personnel, Equipment, Supplies and Documentation/Data Entry 2015 2016
| CMR Requirements |
| 1-50 personnel |
| 51-100 personnel |
| 101-150 personnel |
| 151-200 personnel |
| 201-250 personnel |
| 251-300 personnel |
| 301-350 personnel |
| 351-400 personnel |
| 401-450 personnel |
| 451-500 personnel |
| I acknowledge that I have read and understand the Statement of Work. |
| Vendor Name |
| Vendor Address |
| Authorizing Individual |
| Signature |
| Phone Number |
| E-Mail Address |
File details come from the government source that posted it. Updated .