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Orange County Proposed Fee Schedule-FY 2010-11 <br /> Pro�fosed Fee Change for FY Last <br /> De artmenUPro ram Description Current Fee �d�0-11�", ' Revision <br /> .Amal One Surface Prui�/Pemi $89.00 � � � ����2009 <br /> Amal Two Surface Prun/Penn $l 13.00 2009 <br /> M�al Three Surface Pru»/Pemi $137.00 2009 <br /> fvnalFoutSurface PruidPemi 5156.00 2009 <br /> Resin One Surface Mterior $94.00 zppg <br /> Resin Two Sudace Anterior $I I8.00 2009 <br /> Resin Three Surface Mterior $141.00 2009 <br /> Resin Four Surface Anterior a 164.00 2009 <br /> Resin Com .Crown Ant.Prim $185.00 2009 <br /> Resin Com .1sur.Post-Prin✓Pemi 5115.00 2009 <br /> Resin Com.2sur.Post-Prim/Penn $157.00 2009 <br /> Resin Com.3sur.Pos[erior Penn a207.00 Zppg <br /> Resin Com .4+sur.Posterior Pem� $242.00 � 2009 <br /> A lica[ion of Desensi[izin Medicamen[ $37.00 2009 <br /> Application of Desensitizing Resin for cervical <br /> and/orrootsurface ertooth s52.00 2009 <br /> Pul orom $119.00 2009 <br /> SSC Pr' Tooth $201.00 2009 <br /> SSC Pennanent Tooth $229.00 2009 <br /> Prebacricated Resin Crowu $235.00 2009 <br /> Prefab.est.coat SSC rim.Tooth $214.00 2009 <br /> Sedative Fillin $74.00 Zpp9 <br /> � Palliative Treatrnent $60.00 Zpp9 <br /> Ext.Eru ted Too[h Prim/Pevn S89.00 2009 <br /> � Extraction Sur ical-100+ $141.00 � 2009 <br /> Ex[.comal renman[s deciduous $62.00 2009 <br /> Alveo las extrac[ions /uad. $I 18.00 Zpp9 <br /> Alveoplasty in conjuction with ectraction l3 <br /> teeth er uadrant $ll8.00 2009 <br /> Alveloplasty not in wnjunetion with extractiou <br /> 4 or more tooth s aces er uadrant $189.00 2009 <br /> Alveloplasry not in conjuction with extraction t <br /> 3 tooth s aces er uadran[ $162.00 2009 <br /> Recement Crown NOT cov.b MA $57.00 2009 <br /> S[ud Models $53.00 2009 <br /> I&D Minor Sur e $186.00 2009 <br /> Ocenlsal Ad'usdnen[Limi[ed $8G.00 � 2009 <br /> Frach�red Tooth Txt. $70.00 2009 <br /> Pul Ca-d'vect ex .PuI MED $46.00 2009 <br /> Pul Ca-indirect nead ex osed $46.00 Zpp9 <br /> Bio s Oral Tissue $I51.00 Zppg <br /> Pin Retention/toodi $30.00 2009 <br /> (1)My fee changes will be included in[his column; �' <br /> a blank beside each fee nxans there is no fee change in FY 2010-I l Proposed Fee Schedule W <br />