Orange County NC Website
Browse       Search
Fee Adjustments for Denta( Health Services <br />Orange County Health Department <br />October 2004 <br />ADA DESCRIPTION OF SERVICE OCIID MEDICAID NEW OCHD <br />CODES PRESENT FEE RECOmmENDED <br /> FEE FEE <br /> 100% <br />DO150 COMPREI1BNStvE ORAL. $41.00 $45A0 $45.00 <br /> EVALUATION <br />D2335 RESIN FOUR SURFACE $115,00 $116.07 $118,00 <br /> ANTERIOR <br />D2930 STAINL.ESSSTEEL.CROWN $125.00 $144,25 $145.00 <br /> PRIMARY <br />D2933 PREFABRICATED SSC W RESIN $150.00 $181.77 $182..00 <br /> WINDOW <br />DO170 RE-EVALUATION-LIMITED, NEW $20,.00 $25.00 <br /> PROBLEM FOCUSED <br />D1204 TOPICAL.APPL[CATIONOF NEW $15.44 $27.00** <br /> FLUORIDE-ADULT LIMITED TO <br /> RECIPIENTS 1.3-20 YEARS OF <br /> AGE <br />**CHAROE IS THE SAME AS THIS SERVICE PROVIDED FOR CHILDREN UNDER THE AGE OF 13 <br />