Schedule of Prices for Special Dental Services Requiring Prior Approval Sample Clauses

Schedule of Prices for Special Dental Services Requiring Prior Approval. The payments you will receive, per Service provided, for the Services described in clause E5.7 are as follows: Item Code Price (GST excl.) 2023/24 Minor surgical operation or other time-based procedures (first half hour) MSO1 $97.52 Minor surgical operation to other time-based procedures (each additional quarter hour) MSO2 $48.74 Treatment of periodontal disease PDT1 $76.61 Acrylic partial denture DEN3 $765.09 Acrylic partial denture -each extra tooth DEN4 $59.33 Acrylic partial denture -each clasp DEN5 $30.82 Gold Crown (partial or full coverage) CRN4 $970.55 Complex reconstruction in composite resin CRN5 $202.02 Cast post and core PST1 $273.79 Preformed post and core PST2 $113.67 Labial composite veneer VEN2 $135.86 Bite splints SPLT $ 513.41 Denture full upper or lower DEN6 $1,084.50 Denture upper and lower DEN7 $2,397.33 Apexification APX1 $171.91 Root Canal treatment and root fillings in permanent molar teeth (per canal treated) including all necessary radiographs performed during treatment and a mandatory post-operative radiograph for the patient's record. RCT5 $313.35 Payment for these Services will be based on the information reported by you as required by clause E10. These additional Services may only be provided with the prior approval of an Approving Dental Officer. Where the prior approval of an Approving Dental Officer is not sought but an application is made subsequently and not approved, then neither the patient nor we will be liable to pay for those Services.
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Schedule of Prices for Special Dental Services Requiring Prior Approval. The payments you will receive, per Service provided, for the Services described in clause E5.7 are as follows: Item Code Price (GST excl.) 2020/21 Minor surgical operation or other time based procedures (first half hour) MSO1 $ 89.41 Minor surgical operation to other time based procedures (each additional quarter hour) MSO2 $ 44.69 Treatment of periodontal disease PDT1 $ 70.24 Acrylic partial denture DEN3 $ 701.43 Acrylic partial denture -each extra tooth DEN4 $ 54.39 Acrylic partial denture -each clasp DEN5 $ 28.25 Gold Crown (partial or full coverage) CRN4 $ 889.80 Complex reconstruction in composite resin CRN5 $ 185.21 Cast post and core PST1 $ 251.02 Preformed post and core PST2 $ 104.22 Labial composite veneer VEN2 $ 124.56 Bite splints SPLT $ 470.70 Denture full upper or lower DEN6 $ 994.27 Denture upper and lower DEN7 $ 2,197.87 Apexification APX1 $ 157.61
Sample 1
Schedule of Prices for Special Dental Services Requiring Prior Approval. The payments you will receive, per Service provided, for the Services described in clause E5.6 are as follows: Item Code Price (GST excl.) 2011/2012 price Minor surgical operation or other time based procedures (first half hour) MSO1 $79.04 Minor surgical operation, periodontal treatment or other time based procedures (each additional quarter hour) MSO2 $39.52 Acrylic partial denture DEN3 $416.13 Acrylic partial denture – each clasp DEN5 $24.97 Acrylic jacket crown CRN4 $520.89 Complex reconstruction in composite resin CRN5 $163.75 Cast post and core PST1 $221.92 Preformed post and core PST2 $92.15 Labial composite veneer VEN2 $110.13 Panoramic radiograph RAD2 $38.07 Occlusal radiograph RAD3 $25.61 Splints for bruxism or TMJ problems SPLT $416.13 Denture full upper or lower DEN6 $879.04 Dentures upper and lower DEN7 $1303.96 Pulpotomy in permanent tooth RCT4 $89.36 Apexification. APX1 $139.34
Sample 1
Schedule of Prices for Special Dental Services Requiring Prior Approval. The payments you will receive, per Service provided, for the Services described in clause E5.7 are as follows: Items Code Price (GST excl.) 2022/23 Minor surgical operation or other time based procedures (first half hour) MSO1 $ 93.37 Minor surgical operation to other time based procedures (each additional quarter hour) MSO2 $ 46.66 Treatment of periodontal disease PDT1 $ 73.35 Acrylic partial denture DEN3 $ 732.49 Acrylic partial denture -each extra tooth DEN4 $ 56.80 Acrylic partial denture -each clasp DEN5 $ 29.51 Gold Crown (partial or full coverage) CRN4 $ 929.20 Complex reconstruction in composite resin CRN5 $ 193.41 Cast post and core PST1 $ 262.13 Preformed post and core PST2 $ 108.83 Labial composite veneer VEN2 $ 130.07 Bite splints SPLT $ 491.54 Denture full upper or lower DEN6 $ 1,038.30 Denture upper and lower DEN7 $ 2,295.19 Apexification APX1 $ 164.59
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