Cigna charge schedule
WebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (K1-09) 92249.a - 4 - Patient Charge Code Procedure Description Additional prophylaxis (cleaning) – In addition to the 2 $30.00 prophylaxes (cleanings) allowed per calendar year Topical application of fluoride varnish (limit 2 per calendar year). $0.00 WebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (Q5ZV0) 92260.a - 5 - Patient Charge Code Procedure Description Preventive resin restoration in a moderate to high caries risk 0% patient – Permanent tooth D1352 D1353 Sealant repair – Per tooth 0% D1354 Interim caries arresting medicament application 0%
Cigna charge schedule
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WebThis Patient Charge Schedule applies only when covered alveolar services are performed by your Network Dentist, unless differently authorized by Cigna Dental. These codes … WebCIGNA Dental Care® Patient Charge Schedule (DC-07) Code Procedure Description Patient Coinsurance Restorative (Fillings) D2140 Amalgam – 1 Surface, Primary or …
Webcigna dental care® patient cHarge scHedule Code Procedure Description Patient Charge D0180 Comprehensive periodontal evaluation – New or established patient $70.00 D0210 X-rays intraoral – Complete series of radiographic images (limit 1 every 3 years) $0.00 D0220 X-rays intraoral – Periapical – First radiographic image $0.00 WebNov 5, 2024 · Cigna Dental HMO Patient Charge Schedule; Cigna Dental PPO Benefit Summary; Vision Plan Summary; SmartBenefits Enrollment Application & Change …
WebThe information, tools, and resources you need to support the day-to-day needs of your office WebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (G1-09) 92249.a - 4 - Patient Charge Code Procedure Description Additional prophylaxis (cleaning) – In addition to …
WebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (P5X00) 92256.a - 5 - Patient Charge Code Procedure Description Preventive resin restoration in a moderate to high caries risk $10.00 patient – Permanent tooth D1352 D1353 Sealant repair – Per tooth $7.00 D1354 Interim caries arresting medicament application $0.00
WebUse this form to request a Cigna Dental Care patient charge schedule. Patient Charge Schedules are available to Cigna Dental Care members only. If you have PPO or … flagstaff az albertsons grocery storeWebCigna Dental Care ® Patient Charge Schedule (P6XV0)-2-Code Procedure Description Patient Charge. Office Visit Fee (Per patient, per office visit in addition to any other … canon mg2922 ink absorber replacementWebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (B1I09) 92249.a - 5 - Patient Charge Code Procedure Description Preventive resin restoration in a moderate to high caries risk $0.00 patient – Permanent tooth D1352 D1353 Sealant repair – Per tooth $0.00 D1354 Interim caries arresting medicament application $0.00 flagstaff az annual weatherWebCIGNA DENTAL CARE PATIENT CHARGE SCHEDULE (L1-09) 92249.a - 5 - Patient Charge Code Procedure Description D2150 Amalgam – 2 surfaces, primary or permanent $6.00 D2160 Amalgam – 3 surfaces, primary or permanent $12.00 D2161 Amalgam – 4 or more surfaces, primary or permanent $18.00 canon mg 2922 pixma drivers windows 10Web› Procedures listed on the Patient Charge Schedule are subject to the plan limitations and exclusions described in your plan book/certificate of coverage and/or group contract. › All patient charges correspond to the Patient Charge Schedule in effect on the date the procedure is initiated. 92260.a - 2 - CIGNA DENTAL CARE PATIENT CHARGE ... canon mg2922 printer softwareWebcigna dental care® patient cHarge scHedule Code Procedure Description Patient Charge D0170 Reevaluation – Limited, problem focused (not postoperative visit) $0.00 D0180 Comprehensive periodontal evaluation – New or established patient $33.00 D0210 X-rays intraoral – Complete series of radiographic images (limit 1 every 3 years) $0.00 canon mg 2922 instructionsflagstaff az and surrounding towns