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Home My WebLink AboutC.054.93011_06645. Request for Approval of Budget Amendment #44 for the Recognition of Additional Grant Funds ($11,354) from the Criminal Justice Partnership Program and for Appropriation to the Appropriate Punishment Options Agency: Finance Director Blumenstein explained during the briefing that the state had approved an additional $11,354 for the local criminal justice partnership program. She said a budget amendment was needed to disburse the funds to Appropriate Punishment Options, the administrator of the program. 6. Request from the Health Department for Approval of a Revision to the 2004- 05 Dental Fee Schedule Effective May 2, 2005: Health Director Donna Campbell said at the agenda briefing that originally the Dental Clinic served K -12'h grade children with Medicaid. She said now, the services had been extended to include children covered by insurance and those paying on a sliding fee schedule. Campbell requested approval of the following revisions to the fee schedule. ALLIED HEALTH DENTAL CODES CDT Cod Service Description 2003-2004 20042005 Revised May 2,200 D0120 Recall exam $29.00 $29.00 $34.00 D0140 Eexam $39.00 $39.00 $48.00 D0150 Initial oral exam $50.00 $50.00 $60.00 D0210 Co Tete series x-rays $76.00 $76.00 $87.00 D0220 C Periapical x-ray $14.00 $14.00 $19.00 D0230 Periapical - two or more $12.00 I $12.00 $16.00 D0240 Occlusal P.A. $24.00 1 $24.00 $29.00 D0270 Bitewings -sinle film $12.00 I $12.00 $19.00 D0272 Bitewings - x 2 $23.00 $23.00 $31.00 D0274 Bitewings - x 4 $42.00 542.00 $43.00 D0330 Panorex x-rays $60.00 S60.00 $76.00 D1110 Pro h adult 13 and older $50.00 $50.00 $63.00 D1120 Pr h child age less than 13 $38.00 $38.00 546.00 D1201 Pro h w/fluoride child<13 $51.00 $51.00 $65.00 D1203 Pro h w/fluoride varnish <13 $20.00 $20.00 $26.00 D1204 Floride varnish 13-20 $25.00 $25.00 $26.00 D1205 Prophy w/fluoride adult 13> $62.00 $62.00 $62.00 D1330 Oral Hyg. Under 3 years $25.00 $25.00 $25.00 D1351 Sealants $32.00 $32.00 $37.00 D1510 Space Maint. Fixed -Unilateral $209.00 $209.00 $224.00 D1515 Space Maint. Fixed -Bilateral $419.00 $419.00 $425.00 D1520 Remove Spc Maint. Unilateral $80.00 $80.00 $150.00 D1525 Remvl Spc Maint. Bilateral $85.00 $85.00 $160.00 D1550 Recement Space Maint $60.00 $60.00 $60.00 D2140 Amalgam 1 surf -perri/primary $66.00 $66.00 $88.00 D2150 Amal am 2 surf-perm/primary $83.00 $83.00 $114.00 D2160 Amalgam 3 surferm/ ri $102.00 $102.00 $140.00 D2161 Amalgam 4 surf-rm/ ri $124.00 1 $124.00 $167.00 D2330 Resin 1 surf -anterior $78.00 $78.00 $105.00 D2331 Resin 2 surf -anterior $95.00 $95.00 $131.00 D2332 Resin 3 surf -anterior $120.00 $120.00 $162.00 D2335 Resin 4 surf -anterior $141.00 $141.00 $175.00 D2390 I Resin based composite crown anterior $167.00 $167.00 $275.00 D2391 Resin based composite I surface $80.00 $80.00 $118.00 D2392 Resin based composite 2 surface $120.00 $120.00 $158.00 D2393 Resin based composite 3 surface $160.00 $160.00 $1%.00 D2394 Rain based composite 4 or more surraces $190.00 $190.00 $237.00 D2920 Recement Crown $60.00 $60.00 $75.00 D2930 SSC- $145.00 $145.00 $185.00 D2931 SSC -permanent $174.00 $174.00 $219.00 D2940 Sedative filling $59.00 $59.00 $72.00 D2950 Crown build-up $100.00 $100.00 $180.00 D2951 I Pin placernent $22.00 $22.00 $45.00 D2970•' I Temporary crown $139.00 $139.00 $220.00 D3110' Pulp cap direct $35.00 $35.00 $57.00 D3220 Pulpotonry Excl.rest $103.00 $103.00 $133.00 D3310 RCT -anterior $369.00 $369.00 $484.00 D3330 RCT -molar $405.00 $405.00 $700.00 D3351 Recalcification -initial visit $174.00 $174.00 $240.00 D3352 Recal-interim medication re lcmnt $125.00 5125.00 $180.00