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Procedures Available with Discount Dental Plans - For Individuals, Families and Groups

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Dental care available, including most of these procedures:
Abutement supported retainer for cast metal FPD(high noble metal)
Abutement supported retainer for cast metal FPD(noble metal)
Abutement supported retainer for cast metal FPD(predominantly base metal)
Abutement supported retainer for porcelain fused to metal FPD (high nobel metal)
Abutement supported retainer for porcelain fused to metal FPD (noble metal)
Abutement supported retainer for porcelain fused to metal FPD (predominantly based metal)
Abutement supported retainer for porcelain/ceramic FPD
Abutment Placement-Endosteal Implant
Accession of tissue, gross & microscopic exam, including assessment of surgical margins for presence of disease, preparation & transmission of written report.
Active treatment phase - up to 24 months
Add Clasp to Existing Partial Denture
Add Tooth to Existing Partial Denture
Adjunctive Services
Adjust Complete Denture-Mandibular
Adjust Complete Denture-Maxillary
Adjust Partial Denture-Mandibular
Adjust Partial Denture-Maxillary
All Teeth/Acrylic On Cast Frame-Mand
All Teeth/Acrylic On Cast Frame-Maxil
Alveoloplasty in Conjunc with Exts-Per Quad
Alveoloplasty Not in Conjunc with Exts-Per Quad
Alveolus-Stabilize Teeth Opn Red Splinting.
Amalgam-Four or More Surfaces, Permanent
Amalgam-Four or More Surfaces, Primary
Amalgam-One Surface, Permanent
Amalgam-One Surface, Primary
Amalgam-Three Surfaces, Permanent
Amalgam-Three Surfaces, Primary
Amalgam-Two Surfaces, Permanent
Amalgam-Two Surfaces, Primary
Analgesia
Apex./Recal.Initial Visit (Ap. Clos./Cal.Rep.Etc)
Apex/Recal-Interim Medication Replacement
Apexification/Recalcification-Final Visit
Apically Position Flap
Apicoectomy (Per Tooth) Each Additional Root
Apicoectomy/Periradicular Surgery (Ea. Add'l Root)
Apicoectomy/Periradicular Surgery-Anterior
Apicoectomy/Periradicular Surgery-Bicuspid (First Root)
Apicoectomy/Periradicular Surgery-Molar (First Root)
Application of Desnsitizing Resin/Cervical Root Surf
Application-Desensitizing Medicament
ARTHROCENTESIS
ARTHROPLASTY
ARTHROSCOPY-DIAG. W/ OR W/O BIOPSY
ARTHROSCOPY-SURG: DISC REOPS/STABIL
ARTHROSCOPY-SURG: LAVAGE/LYSIS ADHS
ARTHROSCOPY-SURG: SYNOVECTOMY
ARTHROSCOPY-SURGICAL; DEBRIDEMENT
ARTHROTOMY
ARTROSCOPY-SURG; DISCECTOMY
AURICULAR PROSTHESIS
Bacteriologic Studies for Path Agents
Behavior Management
BEHAVIOR MANAGEMENT, BY REPORT
Biopsy of Oral Tissue-Hard
Biopsy of Oral Tissue-Soft
Bitewings-Four Films
Bitewings-Single Film
Bitewings-Two Films
Bleaching of Discolored Tooth
Bone Replacement Graft First Site in Quadrant
Bone Replacement Graft-Ea. Add'l Site in Quadrant
Bridge Repair
Broken Appointment (Less than 24 Hour Notice)
Canal Prep and Fitting of Preformed Dowel/Post
Caries Susceptability Tests
Case presentation, detailed and extensive treatment planning
Cast Post and Core in Addition to Crown
Cast Post and Core/Addition to Bridge Retainer
Cast Post Part of Bridge Retainer
Cephalometric Film
Class I Malocclusion, 1 Arch
Class I Malocclusion, Both Arches
Class II Malocclusion, 1 Arch
Class II Malocclusion, Both Arches
Class III Malocclusion, 1 Arch
Class III Malocclusion, Both Arches
Clinical Crown Lengthening-Hard Tissue
CLOSURE OF SALIVARY FISTULA
Combo Connect Tissue & Dbl Ped Graft
COMMISSURE SPLINT
Comp Perio Evaluation
Complete Denture-Mandibular
Complete Denture-Maxillary
COMPLETE ORTHO TREATMENT 19 AND OVER
COMPLETE ORTHO TREATMENT UNDER 19
Complex or Heavily Decayed Tooth
Complicated Suture greater than 5 CM, Meticulous Closure
Complicated Suture up to 5 CM, Meticulous Closure
Composite Resin Crown-Anterior-Permanent
Composite Resin Crown-Anterior-Primary
Composite/Resin-Inlay One Surface Lab Processed
Comprehensive Oral Evaluation
Comprehensive Ortho Treatment of the Adolescent Dentition
Comprehensive Ortho Treatment of the Adult Dentition
Comprehensive Ortho Treatment of the Transitional Dentition
CONDYLECTOMY
Connector Bar
Consultation
Coping-Metal
Core Buildup for Retainer, Including Any Pins
Core Build-Up, Including Any Pins
Coronal Remnants - Deciduous Tooth
CORONOIDECTOMY
Cosmetic Bonding
Crown - Porcelain/Ceramic
Crown (Resin with Noble Metal)
Crown Repair
Crown-3/4 Cast High Noble Metal
Crown-3/4 Cast Metallic
Crown-3/4 Cast Noble Metal
Crown-3/4 Cast Porcelain / Ceramic
Crown-3/4 Cast Predominantly Base Metal
Crown-Bridge Retainer-Resin Predom. Base Metal
Crown-Bridge Retainer-Resin with High Noble Metal
Crown-Full Cast High Noble Metal
Crown-Full Cast Noble Metal
Crown-Full Cast Predominately Base Metal
Crown-Porcelain Fused to High Noble Metal
Crown-Porcelain Fused to Noble Metal
Crown-Porcelain Fused to Predominately Base Metal
Crown-Porcelain/Ceramic Substrate
Crown-Resin with High Noble Metal
Crown-Resin with Noble Metal
Crown-Resin with Predominately Base Metal
Crown-Resin-Laboratory
Crown-Retainer 3/4 Cast High Noble Metal
Crown-Retainer-3/4 Cast Noble Metal
Crown-Retainer-3/4 Cast Porcelain / Ceramix
Crown-Retainer-3/4 Cast Predom. Base Metal
Crown-Retainer-Full Cast High Noble Metal
Crown-Retainer-Full Cast Noble Metal
Crown-Retainer-Full Cast Predom. Base Metal
Crown-Retainer-Porcelain Fused High Noble Metal
Crown-Retainer-Porcelain Fused Predom. Base Metal
Crown-Retainer-Porcelain Fused to Noble Metal
Cytology sample collection
Destroy Lesion by Electsrg/Chmtpy/Cryotpy Etc.
Detailed Exten Oral Eval-Problem Focus-By Report
Diagnostic
Diagnostic Casts
Diagnostic Photographs
Diagnostic work up-x-rays, study models, treatment plan
Dietary Planning - Control of Dental Caries
Difficult cleaning, heavier scaling
DISC REPAIR
Disposables
Distal Wedge Procedure
Each Additional Cast - Sane Tooth
Each Additional Prefab Post - Same Tooth
Each additional tooth
Each Additonal Prefab Post - Same Tooth
Each Addl. Cast Post - Same Tooth
Each Addl. Prefab Post - Same Tooth
Emergency Oral Examination
EMERGENCY TRACHEOTOMY
Enamel Microabrasion
Endodontic Endosseous Implant
Endodontics
Excision of benign lesion greater than 1.25cm
Excision of benign lesion, complicated
Excision of Benign Tumor Lesion < 1.25 CM
Excision of Benign Tumor Lesion > 1.25 CM
Excision of Hyperplastic Tissue/Per Arch
Excision of malignant lesion greater than 1.25cm
Excision of malignant lesion up to 1.25cm
Excision of Malignant Tumor Lesion < 1.25 CM
Excision of Malignant Tumor Lesion > 1.25 CM
Excision of Pericoronal Gingiva
EXCISION-SALIVARY GLAND, BY REPORT
External Bleaching Per Arch
External Bleaching Per Tooth
Extraction, Erupt Tth Or Exposed Root
Extraction-Each Additional Tooth
Extraction-Single Tooth
Extraoral-Each Additional Film
Extraoral-First Film
Fabrication of Athletic Mouthguard
FACIAL AUGMENTATION IMPLANT PROSTH.
FACIAL MOULAGE (COMPLETE)
FACIAL MOULAGE (SECTIONAL)
FACIAL PROSTHESIS, REPLACEMENT
Failed Appointment (Without 24-Hours Notice)
FEEDING AID
Final ortho records
FINAL WORKUP & X-RAYS
Fixed Appliance Therapy
Fixed Appliance Therapy (to age 18)
Fixed retention appliance therapy-per arch
Fixed tooth guidance appliance therapy
Fluroide Gel Carrier
Free Soft Tissue Graft Proc. (Include Donor Site Surg)
Frenulectomy (Frenectomy/Frenotomy) Sep. Proc.
Full Mouth Debride-Enable Periodontal Eval & DX
General Anesthesia-Each Additional 15 Minutes
General Anesthesia-First 30 Minutes
Gingival Curettage, Surgical, Per Quad, By Report
Gingival Flap Procedure Incl Root Planing/Quad
Gingival Flap, W/ Rt Pln - 1 to 3 Tth /Quad
Gingivectomy or Gingivoplasty-Per Quadrant
Gingivectomy or Gingivoplasty-Per Tooth
Gold Foil-One Surface
Gold Foil-Three Surfaces
Gold Foil-Two Surfaces
Gross Pulpal Debridement - Primary & Permanent Teeth
Guided Tissue Regen-Non Resorb Per Site, Tooth
Guided Tissue Regen-Resorb Barrier/Site/Tooth
Hemisection (Incl Root Removal) Not Incl Endo
Histopathologic Examinations
Immediate Denture-Mandibular
Immediate Denture-Maxillary
Implant Connecting Bar
Implant Maintenance Procedures
Implant Mand. For Augmentation Purposes
Implant Removal
Implant supported retainer for cast metal FPD(titanium,titanium alloy,or high noble metal)
Implant supported retainer for ceramic FPD
Implant supported retainer for porcelain fused to metal FPD(titanium,titanium alloy,or high noble metal)
IMPLANT-FAC. BONE/HOMOL/HETERO/ALLO
IMPLANT-MAND AUGMENT (EXCL ALVEO) BR
IMPLANT-OTHER THAN FACIAL BONES
Incision and Drainage Abscess Extraoral-Soft Tissue
Incision and Drainage Abscess Intraoral-Soft Tissue
Incomplete Endodontic Therapy - Inoper/fx tooth
Initial ortho. appliance, construction and installation
INITIAL WORKUP & X-RAYS
Inlay Metallic 3 Surfaces
Inlay/Onlay Porcelain/Ceramic
Inlay-Cast Hi Noble, 2 Surf
Inlay-Cast Hi Noble, 3+ Surf
Inlay-Cast Noble, 2 Surf
Inlay-Cast Noble, 3+ Surf
Inlay-Cast Predom Base Metal, 2 Surf
Inlay-Cast Predom Base Metal, 3+ Surf
Inlay-Composite/Resin-Three or > Surf (Lab. Processed)
Inlay-Composite/Resin-Two Surfaces (Lab. Processed)
Inlay-Metallic-One Surface
Inlay-Metallic-Three or More Surfaces
Inlay-Metallic-Two Surfaces
Inlay-Porc/Ceramic, 2 Surf
Inlay-Porc/Ceramic, 3+ Surf
Inlay-Porcelain/Ceramic-One Surface
Inlay-Porcelain/Ceramic-Three or More Surfaces
Inlay-Porcelain/Ceramic-Two Surfaces
Int. Root Repair-Perforation Defec.
Intentional Replantation Include Necessary Splinting
INTERCEPTIVE PRE-ORTHO GUIDANCE/VISIT
Interceptive Treatment of the Primary Dentition
Interceptive Treatment of the Transitional Dentition
Interim Complete Denture (Mandibular)
Interim Complete Denture (Maxillary)
Interim Partial Denture (Mandibular)
Interim Partial Denture (Maxillary)
Internal Bleaching Per Tooth
Intraoral-Complete Series Including Bitewings
Intraoral-Occlusal Film
Intraoral-Periapical-Each Additional Film
Intraoral-Periapical-First Film
Intravenous Sedation-Val./Dem.
IV Sedation / Analgesia - Each Additional 15 Minutes
IV Sedation / Analgesia - First 30 Minutes
JOINT RECONSTRUCITON
Labial Veneer (Laminate)-Chairside
Labial Veneer (Porcelain Laminate)-Laboratory
Labial Veneer (Resin Laminate)-Laboratory
LEFORT I MAXILLA-SEGMENTED
LEFORT I MAXILLA-TOTAL
LEFORT II OR LEFORT III/BONE GRAFT
LEFORT II/III OSTEO-FAC BONE W/O GR
Limited Oral Evaluation-Problem Focused
Limited ortho treatment adult-over age 19
Limited Ortho Treatment of the Adolescent Dentition
Limited Ortho Treatment of the Adult Dentition
Limited Ortho Treatment of the Primary Dentition
Limited Ortho Treatment of the Transitional Dentition
Local Anesthesia
Local Anesthesia Not in Conjunc with Operative
Localized Chemotheraputic Agents
LOST OR BROKEN HEAD GEAR
LOST OR BROKEN METAL BANDS
LOST OR IRREPARABLE RETAINER
MAND RESECT PROSTHESIS W/ GUIDE FLG
MAND RESECT PROSTHESIS W/O GD FLANG
Mandibular Part Denture-Metal Frame with Resin Base
Mandibular Part Denture-Resin Base (Clasp/Rests)
Manipulation Under Anesthesia
Maxillary Part Denture-Metal Frame with Resin Base
Maxillary Part Denture-Resin Base (Clasp/Rests)
Maxillary Sinsotomy for Removal Th. Frgmt/FB
Medicinal Application/Irrigation Per Visit
Metallic-Onlay 2 Surfaces
Metallic-Onlay 3 Surfaces
Metallic-Onlay 4 or More Surfaces
Misc/No ADA ID
Mucogingival Surgery-Per Quadrant
MYOTOMY
NASAL PROSTHESIS
OBTURATOR PROSTHESIS, DEFINITIVE
OBTURATOR PROSTHESIS, INTERIM
OBTURATOR PROSTHESIS, SURGICAL
OCCLUSAL GUARD, BY REPORT
Occlusal Guards
Occlusal Othotic Appliance
Occlusion Adjustment-Complete
Occlusion Adjustment-Limited
Occlusion Analysis-Mounted Case
OCULAR PROSTHESIS
Odontoplasty 1-2 Teeth
Office Visit (After Hours)
Office Visit / Infection Disease Prevention (each visit)
Office Visit fee - Per visit
Office Visit for Obser (Reg. Hours) No Other Servs
Office Visit-After Regular Hours
Office visit-emergency, after regular office hours
Office visit-emergency, regular office hours
OFFICE VISIT-OBSER-REG HRS. NO SERVS
Onlay Metallic 3 Surfaces
Onlay-Cast Hi Noble, 2 Surf
Onlay-Cast Hi Noble, 3+ Surf
Onlay-Cast Noble, 2 Surf
Onlay-Cast Noble, 3+ Surf
Onlay-Cast Predom Base Metal, 2 Surf
Onlay-Cast Predom Base Metal, 3+ Surf
Onlay-Composite/Resin-Four or More Surfaces
Onlay-Composite/Resin-Three Surfaces
Onlay-Composite/Resin-Two Surfaces
Onlay-Metallic 4 or More Surfaces
Onlay-Porc/Ceramic, 2 Surf
Onlay-Porc/Ceramic, 3+ Surf
Oral Antral Fistula Closure
Oral Hygiene Instructions
Oral Reevaluation-Ltd. Problem Focused (Established Pt. - Not Post-Op)
Oral Surgery
Oral/Facial Images (Including Intra & Extraoral)
ORBITAL PROSTHESIS
Orthodontic Retention (Removal, Construction & Placement)
Orthodontic Treatment (Alternative Billing to Set Fee)
Orthodontics
Oseous/Ostprstl/Ctlg Gft. Mndbl. Auto/Nonauto
Oss Surg, w/Flap Entry & Clos - 1 To 3 Tth/Quad
Osseous Surgery Incl Flap Entry/Closure/Quad
Osseous Surgery, incl flap entry and closure 1 to 3 teeth-quad
OSSSEOUS GRAFYT-MAND/FACIAL-AUTO/NON
OSTEOPLASTY-ORTHOGNATHIC DEFORM
OSTEOTMY-RAMUS, OPEN/BONE GRAFT
OSTEOTMY-SEGMENT/SUBAPICAL/QUAD
OSTEOTOMY-BODY OF MANDIBLE
OSTEOTOMY-RAMUS, CLOSED
OSTEOTOMY-RAMUS, OPEN
OTHER DRUGS/MEDICAMENTS, BR
Other Oral Pathology Procedures
Other Temporomandibular Join Films
Overdenture Complete (By Report)
PALATAL AUGMENTATION PROSTHESIS
PALATAL LIFT PROSTHESIS, DEFINITIVE
Palliative (Emergency) Tx-Dental Pain-Minor Procedure
Panoramic Film
PARTIAL OR FUNCTIONAL ORTHO TREATMENT
Partial Osectomy (Guttering/Saucerization)
Pediatric Partial Denture, Fixed
Pedicle Soft Tissue Graft Procedure
Perio Charting
Perio Hygiene Instruction
Perio Maintenance Proc Following Active Therapy
Perio Scal & Rt Pln - 1 To 3 Tth Per Quad
Perio Scaling and Root Planing-Per Quadrant
Periodic Oral Evaluation
Periodic Treatment Visit (as part of Contract)
Periodontics
Pin Retention/Tooth, In Addition to Restoration
Pontic-Cast Base Metal
Pontic-Cast High Noble Metal
Pontic-Cast Noble Metal
Pontic-Porcelain Fused to High Noble Metal
Pontic-Porcelain Fused to Noble Metal
Pontic-Porcelain Fused to Predom. Base Metal
Pontic-Porcelain/Ceramic
Pontic-Resin with High Noble Metal
Pontic-Resin with Noble Metal
Pontic-Resin with Predominately Base Metal
Porcelain/Ceramic-Onlay 2 Surfaces
Porcelain/Ceramic-Onlay 3 Surfaces
Porcelain/Ceramic-Onlay 4 or More Surfaces
Post Removal Not in Conjunction w/Endodontic Therapy
Post Treat. Stabilization, Adult
Post Treat. Stabilization, Child
Posteroanther
Postoperative visits (complications)
Precision Attachment
Prefab Post and Core in Addition to Bridge Ret
Prefab. Stainless Steel Crown with Resin Window
Prefabricated abutement
Prefabricated Post and Core in Addition to Crown
Prefabricated Resin Crown
Prefabricated Stainless Steel Crown-Permanent
Prefabricated Stainless Steel Crown-Primary
Pre-Orthodontic Treatment Visit
Preventive
Primary closure of a sinus perforation
Processing & interpretation of cytologic smears, includes preparation & transmission of written report.
Prof Consult (Diag Serv by Other Dentist/Phys)
Professional Visit-Hospital Call
Professional Visit-House Call
Prophylaxis - adult (difficult cleaning)
Prophylaxis-Adult
Prophylaxis-Child
Prosthodontics (fixed)
Prosthodontics (removable)
Provisional Crown
Provisional pontic
Provisional retainer crown
Provisional Splinting-Extracoronal
Provisional Splinting-Intracoronal
Pulp Cap-Direct (Excluding Final Restoration)
Pulp Cap-Indirect (Excluding Final Restoration)
Pulp debridement/no RCT finish
Pulp Vitality Tests
Pulpal Therapy Resorbable Fill -post Primary Tooth
Pulpal Therapy-Resorbable Fill -ant Primary Tooth
RADIATION CARRIER
RADIATION CONE LOCATOR
RADIATION SHIELD
Radical Excision Lesion < 1.25 CM
Radical Excision Lesion > 1.25 CM
Radical Resection/Mandible with Bone Graft
Rebase Complete Mandibular Denture
Rebase Complete Maxillary Denture
Rebase Mandibular Partial Denture
Rebase Maxillary Partial Denture
Recement Crown
Recement Fixed Partial Denture
Recement Inlay
Recementation of Space Maintainer
Recementation per unit
Re-evaluation Post Treatment
Regional Block Anesthesia
Reimplant or Stab Accid Evul Tooth and/or Alveol
Reline Compete Mandibular Denture (Laboratory)
Reline Complete Mandibular Denture (Chairsid)
Reline Complete Maxillary Denture (Chairside)
Reline Complete Maxillary Denture (Laboratory)
Reline Mandibular Partial Denture (Chairside)
Reline Mandibular Partial Denture (Laboratory)
Reline Maxillary Partial Denture (Chairside)
Reline Maxillary Partial Denture (Laboratory)
Reline partial dent in lab, per arch
Rem Impac. Tooth-Comp Bony/Unusual Complications
Remov Unilat Part Denture-1 Piece Metal (w/Teeth)
Removable Appliance Therapy
Removable Appliance Therapy (to age 18)
Removable retention appliance therapy-per arch
Removable tooth guidance appliance therapy
Removal of Exostosis-Maxilla or Mandible
Removal of Exostosis-Per Site
Removal of Foreign Body Skn/Subcutaneous Areolar Tiss
Removal of Impacted Tooth-Complete Bony
Removal of Impacted Tooth-Partial Bony
Removal of Impacted Tooth-Soft Tissue
Removal of Nonodontogenic Cyst/Tumor/Lesion < 1.25 CM
Removal of Nonodontogenic Cyst/Tumor/Lesion > 1.25 CM
Removal of Odontogenic Cyst/Tumor/Lesion < 1.25 CM
Removal of Odontogenic Cyst/Tumor/Lesion > 1.25 CM
Removal of Torus Mandibularis
Removal of Torus Palatinus
Removal Reaction Produc. Foreign Bodies - Mus/Skl
Repair Broken Complete Denture Base
Repair Cast Framework, Partial Denture
Repair Implant Abutment
Repair Implant-Supported Prosthesis
Repair or Replace Broken Clasp, Partial Denture
Repair Orthodontic Appliance
Repair Resin Denture Base
REPAIR-MAXILLOF SOFT & HARD DEFECT
Replace Broken Teeth-Per Tooth, Partial Denture
Replace Miss/Brkn Teeth-Complete Denture/Tooth
Replace Part Semi-Precision/Precision Attach
Replacement of Lost or Broken Retainer
Resin Comp - 1 Surf Posterior
Resin Comp - 2 Surf Posterior
Resin Comp - 3 Surf Posterior
Resin Comp - 4+ Surf Posterior
Resin Comp Crwn, Ant
Resin, One Surface, Anterior
Resin-Four +Surfaces or Invl Incisal Angle (Anterior)
Resin-Four or More Surfaces, Posterior-Permanent
Resin-Four or More Surfaces, Posterior-Primary
Resin-One Surface, Posterior-Permanent
Resin-One Surface, Posterior-Primary
Resin-Three or More Surfaces, Posterior-Permanent
Resin-Three or More Surfaces, Posterior-Primary
Resin-Three Surfaces, Anterior
Resin-Two Surfaces, Anterior
Resin-Two Surfaces, Posterior-Permanent
Resin-Two Surfaces, Posterior-Primary
Restorative
Retainer Porc Ceramic/Resin Bonded Fixed Prosth
Retainer-Cast Metal-Resin Bonded Fixed Prosthes
Retainer-Inlay-Metallic-Two Surfaces
Retention phase including retainer
Retreatment Previous Root Canal Therapy-Anterior
Retreatment Previous Root Canal Therapy-Bicuspid
Retreatment Previous Root Canal Therapy-Molar
Retrograde Filling-Per Root
Root Amputation-Per Root
Root Canal Obstruction - Non-Surgical Access
Root Canal-Anterior (Excluding Final Restoration)
Root Canal-Bicuspid (Excluding Final Restoration)
Root Canal-Molar (Excluding Final Restoration)
Root Canal-Molar (Excluding Final Restoration) -Four Canals
Root Removal-Exposed Root
Routine adult prophylaxis, (each additional)
Routine child prophylaxis (each additional)
Scaling in the Presence of Gingival Imflammation
SCREENING EXAM
Sealant-Per Tooth
Sedative Filling
Sequestrectomy for Osteomyethelitis
SIALODOCHOPLASTY
Sialography
SIALOLITHOTOMY
Silicate Cement-Per Restoration
SKIN GRAFT (IDENT DEFECT-LOCAT-TYPE)
Soft tissue allograft
Space Maintainer-Fixed-Bilateral
Space Maintainer-Fixed-Unilateral
Space Maintainer-Removable-Bilateral
Space Maintainer-Removable-Unilateral
SPEECH AID PROSTHESIS, ADULT
SPEECH AID PROSTHESIS, PEDIATRIC
Start-up Fees (X-rays, Tracings, Case Studies, Study Models)
Stress Breaker
Subepithelial Connective Tissue Graft Procedure
Surg Exp-Imp/Unerup Tooth for Ortho Include Attach
Surg Procedure for Isolation Tooth with R Dam
Surg Revision Procedure - Per Tooth
Surg. Exp-Imp/Unerup Tooth to Aid Eruption
Surg. Rem or Residual Tooth Roots (Cutting Proc)
Surg. Rem. Erup Tooth Req. Flap/Bone Rem/Sec Tooth
SURGICAL DISCECTOMY: W/ W/O IMPLANT
Surgical Placement Transosseous Implant
Surgical Placement-Endosteal Implant
Surgical Placement-Eposteal Implant
Surgical reduction of fibrous tuberosity
Surgical reduction of osseous tuberosity
Surgical Repositioning of Teeth
Surgical Splint
Suture of Recent Small Wounds up to 5 CM
SYNOVECTOMY
SYNTHETIC GRAFT-MAND/FAC BONES
Temporary Crown (Fractured Tooth)
Temporomandibular Joint Arthrogram
Therapeutic Drug Injection
THERAPEUTIC DRUG INJECTION, BR
Therapeutic Pulpotomy (Excluding Final Restoration)
Tissue Conditioning Mandibular
Tissue Conditioning Maxillary
Tobacco Counseling
Tomographic Survey
Tooth Transplantation
Topical Application of Fluoride Incl/PXS Adult
Topical Application of Fluoride Incl/PXS Child
Topical Application of Fluoride PXS not Incl-Adult
Topical Application of Fluoride PXS not Incl-Child
Total for those up to an including 16
Transseptal Fiberotomy
Trigeminal Division Block Anesthesia
TRISMUS APPLIANCE (NOT FOR TMD TX)
TRMT-COMPLICATIONS/POSTSUR/UNUSUAL
Unschd. Drsg Chng (Not by Treating Dentist)
UNSPEC ORAL SURGERY PROCEDURE, BR
Unspecified adj. procedure, by report
Unspecified Diagnostic Procedure
Unspecified Endodontic Procedure
Unspecified Implant Procedure
Unspecified Orthodontic Procedure (By Report)
Unspecified Periodontal Procedure
Unspecified Removable Prosthetic Procedure
Unspecified Restorative Procedure
UNSPECIFIED TMD THERAPY, BY REPORT
Unspecified, Fixed Prosthodontic Procedure
USNPEC MAXILLOFACIAL PROSTH, BR
Vertical Bitewings-Seven / Eight Films
Vestibuloplasty-Rdg. Extension. 2ndy Epithel.
Vestibuloplasty-Rdg. Extension. w/ Gft.-Reatch. Etc.

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