Group Dental Mappings

This article documents the mappings between the base Group Dental custom form and the default Group Dental plan data capture form in both images and tables. It provides the PromptText for each mapped custom form field and the GUID for its data capture form counterpart.

Fields highlighted in red in the custom form images have no equivalent on the plan data capture form and cannot be mapped.

Mappings are grouped by plan data capture section below. They display in the order in which they display in the data capture form. Only sections that contain mappings display.

General Plan Information

Plan Data Capture Form

Custom Form

Number Policy Data Capture GUID Custom Form PromptText
1 GrpDen_GenInfo_AnnDed-Ind_In GI-I-AnnDedInd
2 GrpDen_GenInfo_AnnDed-Ind_Out GI-O-AnnDedInd
3 GrpDen_GenInfo_AnnDed-Fam_In GI-I-AnnDedFam
4 GrpDen_GenInfo_AnnDed-Fam_Out GI-O-AnnDedFam
5 GrpDen_GenInfo_DedCarryOver_In GI-I-DedCarryover
6 GrpDen_GenInfo_DedCarryOver_Out GI-O-DedCarryover
7 GrpDen_GenInfo_AnnMaxBen_In GI-I-AnnMaxBen
8 GrpDen_GenInfo_AnnMaxBen_Out GI-O-AnnMaxBen

Orthodontia

Plan Data Capture Form

Custom Form

Number Policy Data Capture GUID Custom Form PromptText
1 GrpDen_Ortho_OrthoLifeMax_In GI-I-OrthoLifetimeMax
2 GrpDen_Ortho_OrthoLifeMax_Out GI-O-OrthoLifetimeMax

Diagnostic & Preventative Benefits

Plan Data Capture Form

Custom Form

Number Policy Data Capture GUID Custom Form PromptText
1 GrpDen_DiagPrev_Exams_In Ben-I-D&P-Exams
2 GrpDen_DiagPrev_Exams_Out Ben-O-D&P-Exams
3 GrpDen_DiagPrev_Cleanings_In Ben-I-D&P-Cleanings
4 GrpDen_DiagPrev_Cleanings_Out Ben-O-D&P-Cleanings
5 GrpDen_DiagPrev_Flouride_In Ben-I-D&P-Fluoride
6 GrpDen_DiagPrev_Flouride_Out Ben-O-D&P-Fluoride
7 GrpDen_DiagPrev_SpaceMaint_In Ben-I-D&P-SpcMntnr
8 GrpDen_DiagPrev_SpaceMaint_Out Ben-O-D&P-SpcMntnr
9 GrpDen_DiagPrev_Bitewing_In Ben-I-D&P-BitewiseXrays
10 GrpDen_DiagPrev_Bitewing_Out Ben-O-D&P-BitewiseXrays
11 GrpDen_DiagPrev_DiagXRay_In Ben-I-D&P-DiagXrays
12 GrpDen_DiagPrev_DiagXRay_Out Ben-O-D&P-DiagXrays
13 GrpDen_DiagPrev_Sealants_In Ben-I-D&P-Sealants
14 GrpDen_DiagPrev_Sealants_Out Ben-I-D&P-Sealants

Restorative Benefits

Plan Data Capture Form

Custom Form

Number Policy Data Capture GUID Custom Form PromptText
1 GrpDen_Rest_Amalgam_In Ben-I-RstrtvFillAmalg
2 GrpDen_Rest_Amalgam_Out Ben-O-RstrtvFillAmalg
3 GrpDen_Rest_Composite_In Ben-I-RstrtvFillComp
4 GrpDen_Rest_Composite_Out Ben-O-RstrtvFillComp
5 GrpDen_Rest_StainlessCrowns_In Ben-I-Crwns,I&O-AllMetal
6 GrpDen_Rest_StainlessCrowns_Out Ben-O-Crwns,I&O-AllMetal
7 GrpDen_Rest_PorcelainCrowns_In Ben-I-Crwns,I&O-AllCeramic
8 GrpDen_Rest_PorcelainCrowns_Out Ben-O-Crwns,I&O-AllCeramic
9 GrpDen_Rest_InlayOnlayVen_In Ben-I-Crwns,I&O
10 GrpDen_Rest_InlayOnlayVen_Out Ben-O-Crwns,I&O

Oral Surgery

Plan Data Capture Form

Custom Form

Number Policy Data Capture GUID Custom Form PromptText
1 GrpDen_Surg_SimpleExtract_In Ben-I-OralSurgSimpExtr
2 GrpDen_Surg_SimpleExtract_Out Ben-O-OralSurgSimpExtr
3 GrpDen_Surg_ComplexExtract_In Ben-I-OralSurgSurgExtr
4 GrpDen_Surg_ComplexExtract_Out Ben-O-OralSurgSurgExtr

Other Benefits

Plan Data Capture Form

Custom Form

Number Policy Data Capture GUID Custom Form PromptText
1 GrpDen_OthBen_Endodontic_In Ben-I-Endo
2 GrpDen_OthBen_Endodontic_Out Ben-O-Endo
3 GrpDen_OthBen_Periodontic_In Ben-I-Perio
4 GrpDen_OthBen_Periodontic_Out Ben-O-Perio
5 GrpDen_OthBen_Bridges_In Ben-I-ProsthoBrdg
6 GrpDen_OthBen_Bridges_Out Ben-O-ProsthoBrdg
7 GrpDen_OthBen_PartialDent_In Ben-I-ProsthoParDent
8 GrpDen_OthBen_PartialDent_Out Ben-O-ProsthoParDent
9 GrpDen_OthBen_Dentures_In Ben-I-ProsthoDent
10 GrpDen_OthBen_Dentures_Out Ben-O-ProsthoDent
11 GrpDen_OthBen_ProsRepair_In Ben-I-ProsthoR/R
12 GrpDen_OthBen_ProsRepair_Out Ben-O-ProsthoR/R
13 GrpDen_OthBen_Implants_In OF-I-Implants
14 GrpDen_OthBen_Implants_Out OF-O-Implants

Notes

Plan Data Capture Form

Custom Form

Number Policy Data Capture GUID Custom Form PromptText
1 GrpDen_Notes_Notes Notes1
2 GrpDen_Notes_Notes Notes2
3 GrpDen_Notes_Notes Notes3
4 GrpDen_Notes_Notes Notes4
5 GrpDen_Notes_Notes Notes5
6 GrpDen_Notes_Notes Notes6
7 GrpDen_Notes_Notes Notes7
8 GrpDen_Notes_Notes Notes8
9 GrpDen_Notes_Notes Notes9
10 GrpDen_Notes_Notes Notes10
11 GrpDen_Notes_Notes Notes11
12 GrpDen_Notes_Notes Notes12