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Amal/Rest/Perm/Ant/Bic/ 2 false false false 0 0 1919 0 MODBLIV false 00313 11 P Amal/Rest/Perm/Ant/Bic/ 3 Amal/Rest/Perm/Ant/Bic/ 3 false false false 0 0 1919 0 MODBLIV false 00314 11 P Amal/Rest/Perm/Ant/Bic/3+ Amal/Rest/Perm/Ant/Bic/3+ false false false 0 0 1919 0 MODBLIV false 00315 11 P Amal/Rest/Pit/Fissure/Sur Amal/Rest/Pit/Fissure/Sur false false false 0 0 1919 0 MODBLIV false 00321 11 P Amal/Rest/Perm/Mol/1 Surf Amal/Rest/Perm/Mol/1 Surf false false false 0 0 1919 0 MODBLIV false 00322 11 P Amal/Rest/Perm/Mol/2 Surf Amal/Rest/Perm/Mol/2 Surf false false false 0 0 1919 0 MODBLIV false 00323 11 P Amal/Rest/Perm/W,Mes&dis Amal/Rest/Perm/W,Mes&dis false false false 0 0 1919 0 MODBLIV false 00324 11 P Amal/Rest/Perm/Mol/3 Surf Amal/Rest/Perm/Mol/3 Surf false false false 0 0 1919 0 MODBLIV false 00328 11 P Amal/Rest/Perm/Pit&fissur Amal/Rest/Perm/Pit&fissur false false false 0 0 1919 0 MODBLIV false 00331 11 P Th/Col/Rest/Prim/Cus/1sur Th/Col/Rest/Prim/Cus/1sur false false false 0 0 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Pins/Add/4pin Retentitive Pins/Add/4pin false false false 0 0 1919 0 MODBLIV false 00369 11 P Reduc/Reshape/Deciduous Reduc/Reshape/Deciduous false false false 0 0 1919 0 MODBLIV false 00371 11 P Comp/Prim/Molar 1 Surf Comp/Prim/Molar 1 Surf false false false 0 0 1919 0 MODBLIV false 00372 11 P Comp/Prim/Molar/2 Surf Comp/Prim/Molar/2 Surf false false false 0 0 1919 0 MODBLIV false 00373 11 P Comp/Prim/Molar/ 3 Surf Comp/Prim/Molar/ 3 Surf false false false 0 0 1919 0 MODBLIV false 00374 11 P Comp/Prim/Molar/3+ Surf Comp/Prim/Molar/3+ Surf false false false 0 0 1919 0 MODBLIV false 00378 11 P Pit/Fiss. Rest/Prim/Molar Pit/Fiss. Rest/Prim/Molar false false false 0 0 1919 0 MODBLIV false 00381 11 P 1 Surf/Perm/Bicusp/Comp 1 Surf/Perm/Bicusp/Comp false false false 0 0 1919 0 MODBLIV false 00382 11 P 2surf/Perm/Bicusp/Comp 2surf/Perm/Bicusp/Comp false false false 0 0 1919 0 MODBLIV false 00383 11 P 3 Surf/Perm/Bicusp/Comp 3 Surf/Perm/Bicusp/Comp false false false 0 0 1919 0 MODBLIV false 00384 11 P 3+ Surf/Perm/Bicusp/Comp 3+ Surf/Perm/Bicusp/Comp false false false 0 0 1919 0 MODBLIV false 00388 11 P Pit/Fis/Perm/Bicusp/Rest Pit/Fis/Perm/Bicusp/Rest false false false 0 0 1919 0 MODBLIV false 00391 11 P 1 Surf/Perm/Molar/Comp 1 Surf/Perm/Molar/Comp false false false 0 0 1919 0 MODBLIV false 00392 11 P 2 Surf/Perm/Molar/Comp 2 Surf/Perm/Molar/Comp false false false 0 0 1919 0 MODBLIV false 00393 11 P 2 Surf/Perm/Molar/Incl. 2 Surf/Perm/Molar/Incl. false false false 0 0 1919 0 MODBLIV false 00394 11 P 3+ Surf/Perm/Molar/Comp 3+ Surf/Perm/Molar/Comp false false false 0 0 1919 0 MODBLIV false 00398 11 P Pit/Fis/Perm/Molar/Rest Pit/Fis/Perm/Molar/Rest false false false 0 0 1919 0 MODBLIV false 00481 11 P Extract/Perm/1th/Per Quad Extract/Perm/1th/Per Quad false false false 0 0 1919 0 MODBLIV false 00482 11 P Extract/Perm/2th/Per Quad Extract/Perm/2th/Per Quad false false false 0 0 1919 0 MODBLIV false 00483 11 P Extract/Perm/3th/Per Quad Extract/Perm/3th/Per Quad false false false 0 0 1919 0 MODBLIV false 00484 11 P Extract/Perm/4th/Per Quad Extract/Perm/4th/Per Quad false false false 0 0 1919 0 MODBLIV false 00491 11 P Extract/Prim/1th/Per Quad Extract/Prim/1th/Per Quad false false false 0 0 1919 0 MODBLIV false 00492 11 P Extract/Prim/2th/Per Quad Extract/Prim/2th/Per Quad false false false 0 0 1919 0 MODBLIV false 00493 11 P Extract/Prim/3th/Per Quad Extract/Prim/3th/Per Quad false false false 0 0 1919 0 MODBLIV false 00494 11 P Extract/Prim/4th/Per Quad Extract/Prim/4th/Per Quad false false false 0 0 1919 0 MODBLIV false 00495 11 P Extract/Prim/5th/Per Quad Extract/Prim/5th/Per Quad false false false 0 0 1919 0 MODBLIV false 00496 11 P Extract/Prim/6th/Per Quad Extract/Prim/6th/Per Quad false false false 0 0 1919 0 MODBLIV false 00499 11 P Extract/Surgical/Erupted Extract/Surgical/Erupted false false false 0 0 1919 0 MODBLIV false 00501 11 P Endo/Sedative Dressing Endo/Sedative Dressing false false false 0 0 1919 0 MODBLIV false 00502 11 P Endo/Pulpotomy Endo/Pulpotomy false false false 0 0 1919 0 MODBLIV false 00503 11 P Endo/Root Canal/Perm Ant Endo/Root Canal/Perm Ant false false false 0 0 1919 0 MODBLIV false 00601 11 P Frac/Ant/Emergency Care Frac/Ant/Emergency Care false false false 0 0 1919 0 MODBLIV false 00602 11 P Frac/Ant/Intermediate Car Frac/Ant/Intermediate Car false false false 0 0 1919 0 MODBLIV false 00611 11 P Emergency Treatment1/4hr Emergency Treatment1/4hr false false false 0 0 1919 0 MODBLIV false 00612 11 P Oral Infections/ 1/4 Hr Oral Infections/ 1/4 Hr false false false 0 0 1919 0 MODBLIV false 00613 11 P Post Operative Hemm/1/4hr Post Operative Hemm/1/4hr false false false 0 0 1919 0 MODBLIV false 00614 11 P Biopsy Per 1/4 Hr Biopsy Per 1/4 Hr false false false 0 0 1919 0 MODBLIV false 00616 11 P Acrylic/Part,Dent/Replace Acrylic/Part,Dent/Replace false false false 0 0 1919 0 MODBLIV false 00617 11 P Repairs To Part Denture Repairs To Part Denture false false false 0 0 1919 0 MODBLIV false 00701 11 P Hospital Charge Hospital Charge false false false 0 0 1919 0 MODBLIV false 01024 11 B Specific Specific false false false 0 0 false 0 01100 11 P Exam & Diag., Clinical Oral Dental Visit/Orientation false false false 0 0 false 0 01101 11 P Complete Exam, Primary Complete Exam, Primary false false false 1 0 false 01102 11 P Complete Exam, Mixed Complete Exam, Mixed false false false 1 0 false 01103 11 P Complete Exam, Permanent Complete Exam, Permanent false false false 1 0 false 01111 11 P false false false 0 0 1919 0 MODBLIV 0 false 0 01201 11 P Exam, Standard Oral, New Patient Exam, Standard Oral, New Patient false false false 1 0 false 01202 11 P Exam, Previous Patient, Recall Exam, Previous Patient, Recall false false false 1 0 false 01203 11 P Exam/Periodontal Exam/Periodontal false false false 0 0 1919 0 MODBLIV false 01204 11 P Specific / Emergency Exam Specific / Emergency Exam false false false 0 0 1919 0 false 01205 11 P Examination and Diagnosis, Limited Oral, Emergency Examination and Diagnosis, Limited Oral, Emergency false false false 0 0 false 01206 11 P Analysis,Mixed Dentition Analysis,Mixed Dentition false false false 0 0 1919 MODBLIV false 01250 11 P Oral Cert. For Denturists Oral Cert. 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Surgical, General false false false 0 0 false 01602 11 P Exam & Diag, Surgical, Specific Exam & Diag, Surgical, Specific false false false 0 0 false 01701 11 P Exam & Diag, Prosthodontic, Edentulous Exam & Diag, Prosthodontic, Edentulous false false false 1 0 false 01702 11 P Exam & Diag, Specific, Note, Record Exam & Diag, Specific, Note, Record false false false 0 0 false 01703 11 P Exam & Diag, Fixed Oral Rehabilitation Exam & Diag, Fixed Oral Rehabilitation false false false 0 0 false 01801 11 P Complete Endondontic Exam Complete Endondontic Exam false false false 0 0 1919 MODBLIV false 01802 11 P Specific Endodontic Exam Specific Endodontic Exam false false false 0 0 1919 MODBLIV false 01901 11 O Exam & Diag, Ortho, General Exam & Diag, Ortho, General false false false 0 0 false 01902 11 O Exam & Diag, Ortho, Specific, Note, Record Exam & Diag, Ortho, Specific, Note, Record false false false 0 0 false 02101 11 P X-Ray Complete 12 films X-Ray Complete 12 films false false false 0 0 false 02102 11 P Adult, Complete 13 films Adult, Complete 13 films false false false 0 0 false 02111 11 P X-Ray Single Film X-Ray Single Film false true false 0 0 1919 0 false 02112 11 P 2 Films 2 Films false false false 0 0 false 02113 11 P 3 Films 3 Films false false false 0 0 false 02114 11 P 4 Films 4 Films false false false 0 0 false 02115 11 P 5 Films 5 Films false false false 0 0 false 02116 11 P 6 Films 6 Films false false false 0 0 false 02117 11 P 7 Films 7 Films false false false 0 0 false 02118 11 P 8 Films 7 Films false false false 0 0 false 02119 11 P 9 Films 9 Films false false false 0 0 false 02120 11 P 10 Films 10 Films false false false 0 0 false 02121 11 P 11 Films 11 Films false false false 0 0 false 02122 11 P 12 Films 12 Films false false false 0 0 false 02123 11 P 13 Films 13 Films false false false 0 0 false 02124 11 P 14 Films 14 Films false false false 0 0 false 02125 11 P 15 Films 15 Films false false false 0 0 false 02126 11 P Radiographs, Intraoral - Periapical-16 Films false false false 0 0 false 02131 11 P Occlusal Single Film Occlusal Single Film false false false 0 0 false 02132 11 P Occlusal 2 Films Occlusal 2 Films false false false 0 0 false 02133 11 P Occlusal 3 Films Occlusal 3 Films false false false 0 0 false 02134 11 P Occlusal 4 Films Occlusal 4 Films false false false 0 0 false 02135 11 P Radiographs, Intraoral, O Radiographs, Intraoral, O false false false 0 0 1919 0 MODBLIV false 02136 11 P Radiographs, Intraoral, O Radiographs, Intraoral, O false false false 0 0 1919 0 MODBLIV false 02141 11 P Bitewings Single Film Bitewings Single Film false false false 0 0 false 02142 11 P Bitewings 2 Films Bitewings 2 Films false false false 0 0 false 02143 11 P Bitewings 3 Films Bitewings 3 Films false false false 0 0 false 02144 11 P Bitewings 4 Films Bitewings 4 Films false false false 0 0 false 02145 11 P Five Bitewing Films Five Bitewing Films false false false 0 0 1919 0 MODBLIV false 02146 11 P Six Bitewing Films Six Bitewing Films false false false 0 0 1919 0 MODBLIV false 02151 11 P Rgraphs,Reg/Localized, other Single image false false false 0 0 false 0 02152 11 P Rgraphs,Reg/Localized, other Two images false false false 0 0 false 0 02153 11 P Rgraphs,Reg/Localized, other Three images false false false 0 0 false 0 02154 11 P Rgraphs,Reg/Localized, other Four images false false false 0 0 false 0 02159 11 P Rgraphs,Reg/Localized, other Each Additional image Over 4 false false false 0 0 false 0 02201 11 P Extraoral Single Film Extraoral Single Film false false false 0 0 false 02202 11 P Extraoral 2 Films Extraoral 2 Films false false false 0 0 false 02203 11 P Extraoral 3 Films Extraoral 3 Films false false false 0 0 false 02204 11 P Extraoral 4 Films Extraoral 4 Films false false false 0 0 false 02209 11 P Radiographs, Extraoral - Radiographs, Extraoral - false false false 0 0 1919 0 MODBLIV false 02301 11 P Postero - Anterior & Lateral Skull & Facial Bone Single Film Postero - Anterior & Lateral Skull & Facial Bone Single Film false false false 0 0 false 02302 11 P Postero - Anterior & Lateral Skull & Facial Bone 2 Films Postero - Anterior & Lateral Skull & Facial Bone 2 Films false false false 0 0 false 02303 11 P Postero - Anterior & Lateral Skull & Facial Bone 3 Films Postero - Anterior & Lateral Skull & Facial Bone 3 Films false false false 0 0 false 02304 11 P Postero - Anterior & Lateral Skull & Facial Bone 4 Films Postero - Anterior & Lateral Skull & Facial Bone 4 Films false false false 0 0 false 02309 11 P Postero - Anterior & Lateral Skull & Facial Bone Add Film over 4 Postero - Anterior & Lateral Skull & Facial Bone Add Film over 4 false false false 0 0 false 02401 11 P Sialography Single Film Sialography Single Film false false false 0 0 false 02402 11 P Sialography 2 Films Sialography 2 Films false false false 0 0 false 02409 11 P Sialography Add Film over 2 Sialography Add Film over 2 false false false 0 0 false 02411 11 P Radiopaque Dyes, Use Of Radiopaque Dyes, Use Of false false false 0 0 1919 0 MODBLIV false 02412 11 P Radiopaque Dyes, Use Of Radiopaque Dyes, Use Of false false false 0 0 1919 0 MODBLIV false 02419 11 P Radiopaque Dyes, Use Of Radiopaque Dyes, Use Of false false false 0 0 1919 0 MODBLIV false 02501 11 P TMJ Single Film TMJ Single Film false false false 0 0 false 02502 11 P TMJ 2 Films TMJ 2 Films false false false 0 0 false 02503 11 P TMJ 3 Films TMJ 3 Films false false false 0 0 false 02504 11 P TMJ 4 Films each side TMJ 4 Films each side false false false 0 0 false 02509 11 P TMJ Film over 4 TMJ Film over 4 false false false 0 0 false 02511 11 P Arthro/Temp,Mand Joint Arthro/Temp,Mand Joint false false false 0 0 1919 0 MODBLIV false 02521 11 P Interpretation, Arth, 1un Interpretation, Arth, 1un false false false 0 0 1919 0 MODBLIV false 02529 11 P Interpretation, Arth, Add Interpretation, Arth, Add false false false 0 0 1919 0 MODBLIV false 02600 11 P Panoramic Radiograph Panoramic Radiograph false false false 0 0 1919 MODBLIV false 02601 11 P Panoramic Film Panoramic Film false false false 0 0 false 02701 11 P Ceph Single Film Ceph Single Film false false false 0 0 false 02702 11 P Ceph 2 Films Ceph 2 Films false false false 0 0 false 02703 11 P Ceph 3 Films Ceph 3 Films false false false 0 0 false 02704 11 P Ceph 4 Films Ceph 4 Films false false false 0 0 false 02709 11 P Radiographs, Cephalometri Radiographs, Cephalometri false false false 0 0 1919 0 MODBLIV false 02751 11 P Ceph, Tracing and Inter 1 Unit Ceph, Tracing and Inter 1 Unit false false false 0 0 false 02752 11 P Ceph, Tracing and Inter 2 Units Ceph, Tracing and Inter 2 Units false false false 0 0 false 02759 11 P Ceph, Tracing and Inter Add Unit over 2 Ceph, Tracing and Inter Add Unit over 2 false false false 0 0 false 02800 11 P Radiographs, Computerized Axial Tomograms (CAT), Position Emission Tomography (PET), Magnetic Resonance Images(MRI) Interpretation (either the radiographs, CAT scans, PET scans, MRI scans, or the interpretation must be received from another source) Radiographs, Computerized Axial Tomograms (CAT), Position Emission Tomography (PET), Magnetic Resonance Images(MRI) Interpretation (either the radiographs, CAT scans, PET scans, MRI scans, or the interpretation must be received from another source) false false false 0 0 false 0 02801 11 P Radiograph Inter 1 Unit Radiograph Inter 1 Unit false false false 0 0 false 02802 11 P Radiograph Inter 2 Units Radiograph Inter 2 Units false false false 0 0 false 02807 11 P Radiograph Inter 1/2 Unit Radiograph Inter 1/2 Unit false false false 0 0 false 02809 11 P Radiograph Inter Add Unit over 2 Radiograph Inter Add Unit over 2 false false false 0 0 false 02910 11 P Radiographs, Duplications Radiographs, Duplications false false false 0 0 1919 0 MODBLIV false 02911 11 P Duplication Single Film Duplication Single Film false false false 0 0 false 02912 11 P Duplication 2 Films Duplication 2 Films false false false 0 0 false 02913 11 P Duplication 3 Films Duplication 3 Films false false false 0 0 false 02914 11 P Radiographs, Duplications Radiographs, Duplications false false false 0 0 1919 0 MODBLIV false 02915 11 P Radiographs, Duplications Radiographs, Duplications false false false 0 0 1919 0 MODBLIV false 02916 11 P Radiographs, Duplications Radiographs, Duplications false false false 0 0 1919 0 MODBLIV false 02917 11 P Radiographs, Duplications Radiographs, Duplications false false false 0 0 1919 0 MODBLIV false 02918 11 P Radiographs, Duplications Radiographs, Duplications false false false 0 0 1919 0 MODBLIV false 02919 11 P Duplication Add Film over 3 Duplications Add Film over 3 false false false 0 0 false 02921 11 P Duplication of a Complete Series of 12 Films Duplication of a Complete Series of 12 Films false false false 0 0 false 02922 11 P Duplication of a Complete Series of 13 or More Duplication of a Complete Series of 13 or More false false false 0 0 false 02931 11 P Tomography Single View Tomography Single View false false false 0 0 false 02932 11 P Tomography 2 Views Tomography 2 View false false false 0 0 false 02933 11 P Tomography 3 Views Tomography 3 Views false false false 0 0 false 02934 11 P Tomography 4 Views Tomography 4 Views false false false 0 0 false 02939 11 P Tomography Add View over 4 Tomography Add View over 4 false false false 0 0 false 02941 11 P Radiographs, Hand And Wri Radiographs, Hand And Wri false false false 0 0 1919 0 MODBLIV false 02951 11 P Radiography Max Guide Radiography Max Guide true false false 0 0 false 02952 11 P Radiography Mand Guide Radiography Mand Guide true false false 0 0 false 03001 11 P Max Template, Surgical Max Template, Surgical true false false 0 0 false 03002 11 P Mand Template, Surgical Mand Template, Sugical true false false 0 0 false 04101 11 P Test / Analysis, Microbiological Test / Analysis, Microbiological true false false 0 0 false 04201 11 P Test / Analysis, Caries Susceptibility Test / Analysis, Caries Susceptibility true false false 0 0 false 04311 11 P Soft Tissue, Biopsy - by Puncture Soft Tissue, Biopsy - by Puncture true false false 0 0 false 04312 11 P Soft Tissue, Biopsy - by Incision Soft Tissue, Biopsy - by Incision true false false 0 0 false 04313 11 P Biopsy,Soft Tissue,Aspira Biopsy,Soft Tissue,Aspira false false false 0 0 1919 MODBLIV false 04321 11 P Biopsy,Hard Tissue,Punctu Biopsy,Hard Tissue,Punctu false false false 0 0 1919 0 MODBLIV false 04322 11 P Hard Tissue, Biopsy by Incision Hard Tissue, Biopsy by Incision true false false 0 0 false 04323 11 P Biopsy,Hard Tissue,Aspira Biopsy,Hard Tissue,Aspira false false false 0 0 1919 MODBLIV false 04401 11 P Cytological Smear from Oral Cavity Cytological Smear from Oral Cavity true false false 0 0 false 04402 11 P Vital Staining of Oral Mucsal Tissues Vital Staining of Oral Mucsal Tissues true false false 0 0 false 04403 11 P Tests, Cytological DirFluorescence Visualisation false false false 0 0 false 0 04501 11 P Pulp Vitality & Interpretation - 1 Unit Pulp Vitality & Interpretation - 1 Unit false true false 0 0 1919 0 false 04507 11 P Pulp Vitality & Interpretation - 1/2 Unit Pulp Vitality & Interpretation - 1/2 Unit false true false 0 0 1919 0 false 04509 11 P Pulp Vitality And Interpr Pulp Vitality And Interpr false false false 0 0 1919 MODBLIV false 04601 11 P Report,Microbiological Report,Microbiological false false false 0 0 1919 MODBLIV false 04602 11 P Report by Oral Pathologist / Microbiologist Report by Oral Pathologist / Microbiologist true false false 0 0 false 04603 11 P Interpretation & Oral Reports, Cytological by Pathologist Interpretation & Oral Reports, Cytological by Pathologist true false false 0 0 false 04604 11 P Reports, Other Reports, Other false false false 0 0 1919 MODBLIV false 04611 11 P Reports, Intraoperative Reports, Intraoperative false false false 0 0 1919 0 MODBLIV false 04619 11 P Reports, Intraoperative Reports, Intraoperative false false false 0 0 1919 0 MODBLIV false 04621 11 P Interpretation And/Or Rep Interpretation And/Or Rep false false false 0 0 1919 0 MODBLIV false 04629 11 P Interpretation And/Or Rep Interpretation And/Or Rep false false false 0 0 1919 0 MODBLIV false 04631 11 P Radiological Report 1unit Radiological Report 1unit false false false 0 0 1919 0 MODBLIV false 04639 11 P Radiological Report Add U Radiological Report Add U false false false 0 0 1919 0 MODBLIV false 04641 11 P Inter/Rep/Determin/1 Unit Inter/Rep/Determin/1 Unit false false false 0 0 1919 0 MODBLIV false 04649 11 P Inter/Rep/Determin/Add Un Inter/Rep/Determin/Add Un false false false 0 0 1919 0 MODBLIV false 04711 11 P pilot equilibra Complicate - 1 Unit pilot equilibra Complicate - 1 Unit true false false 0 0 false 04712 11 P pilot equilibra Complicate - 2 Units pilot equilibra Complicate - 2 Units true false false 0 0 false 04713 11 P Equilibration, Casts, Dia Equilibration, Casts, Dia false false false 0 0 1919 0 MODBLIV false 04714 11 P Equilibration, Casts, Dia Equilibration, Casts, Dia false false false 0 0 1919 0 MODBLIV false 04719 11 P Equilibration,Casts, Diag Equilibration,Casts, Diag false false false 0 0 1919 0 MODBLIV false 04721 11 P Wax - Up Diag - 1 Unit Wax - Up Diag - 1 Unit true false false 0 0 false 04722 11 P Wax-Up/Diagnostic 2 Units Wax-Up/Diagnostic 2 Units false false false 0 0 1919 0 MODBLIV false 04723 11 P Wax-Up/Diagnostic 3 Units Wax-Up/Diagnostic 3 Units false false false 0 0 1919 0 MODBLIV false 04724 11 P Wax-Up/Diagnostic 4 Units Wax-Up/Diagnostic 4 Units false false false 0 0 1919 0 MODBLIV false 04729 11 P Wax-Up/Diagnostic Add. Wax-Up/Diagnostic Add. false false false 0 0 1919 0 MODBLIV false 04731 11 P Split Cast Mounting, Diag Split Cast Mounting, Diag false false false 0 0 1919 0 MODBLIV false 04732 11 P Split Cast Mounting, Diag Split Cast Mounting, Diag false false false 0 0 1919 0 MODBLIV false 04733 11 P Split Cast Mount. 3 Units Split Cast Mount. 3 Units false false false 0 0 1919 0 MODBLIV false 04734 11 P Split Cast Mount. 4 Units Split Cast Mount. 4 Units false false false 0 0 1919 0 MODBLIV false 04739 11 P Split Cast Mount. Add. Split Cast Mount. Add. false false false 0 0 1919 0 MODBLIV false 04741 11 P Interpretation of Diag Casts - 1 Unit Interpretation of Diag Casts - 1 Unit false false false 0 0 false 04749 11 P Interpretation Of Models Interpretation Of Models false false false 0 0 1919 0 MODBLIV false 04801 11 P Photo - 1 Photo - 1 false false false 0 0 false 04802 11 P Photo - 2 Photo - 2 false false false 0 0 false 04803 11 P Photo - 3 Photo - 3 false false false 0 0 false 04809 11 P Add Photo over 3 Add Photo over 3 false false false 0 0 false 04911 11 P Study Model, Unmounted Study Model, Unmounted true false false 0 0 false 04912 11 P Casts/Diag Unmount Duplic Casts/Diag Unmount Duplic false false false 0 0 1919 0 MODBLIV false 04921 11 P Study Model, Mounted Study Model, Mounted true false false 0 0 false 04922 11 P Study Model, Using Face Bow Transfer Study Model, Using Face Bow Transfer true false false 0 0 false 04923 11 P Study Model, Using Face Bow & Occlusal Records Study Model, Using Face Bow & Occlusal Records true false false 0 0 false 04924 11 P Casts, Diagnostic, Mounte Casts, Diagnostic, Mounte false false false 0 0 1919 MODBLIV false 04931 11 P Orthodontic Model Orthodontic Model true false false 0 0 false 04941 11 P Casts, Diag, Axis & Transfer, Conjunction With 04922 & 04923 Casts, Diag, Axis & Transfer, Conjunction With 04922 & 04923 true false false 0 0 false 04942 11 P 3-D Recording Model, Diag 3-D Recording Model, Diag false false false 0 0 false 04943 11 P Custom Incisal Guide Tabl Custom Incisal Guide Tabl false false false 0 0 1919 0 MODBLIV false 05101 11 P Case Presentation/Treatme Case Presentation/Treatme false false false 0 0 1919 0 MODBLIV false 05102 11 P Case Presentation/Treatme Case Presentation/Treatme false false false 0 0 1919 0 MODBLIV false 05103 11 P Case Presentation/Treatme Case Presentation/Treatme false false false 0 0 1919 0 MODBLIV false 05104 11 P Case Presentation/Treatme Case Presentation/Treatme false false false 0 0 1919 0 MODBLIV false 05109 11 P Case Presentation/Treatme Case Presentation/Treatme false false false 0 0 1919 0 MODBLIV false 05201 11 P Consultation - 1 Unit Consultation - 1 Unit false false false 0 0 false 05202 11 P Consultation - 2 Units Consultation - 2 Units false false false 0 0 false 05209 11 P Consultation - Add Unit over 2 Consultation - Add Unit over 2 false false false 0 0 false 06101 11 P Radio/Intra/Ped/Comp,Ser Radio/Intra/Ped/Comp,Ser false false false 0 0 1919 0 MODBLIV false 06102 11 P Radio/Intra/Adult Comp,Se Radio/Intra/Adult Comp,Se false false false 0 0 1919 0 MODBLIV false 06111 11 P Radio/Intra/Periapical 1 Radio/Intra/Periapical 1 false false false 0 0 1919 0 MODBLIV false 06112 11 P Radio/Intra/Periapical 2 Radio/Intra/Periapical 2 false false false 0 0 1919 0 MODBLIV false 06113 11 P Radio/Intra/Periapical 3 Radio/Intra/Periapical 3 false false false 0 0 1919 0 MODBLIV false 06114 11 P Radio/Intra/Periapical 4 Radio/Intra/Periapical 4 false false false 0 0 1919 0 MODBLIV false 06115 11 P Radio/Intra/Periapical 5 Radio/Intra/Periapical 5 false false false 0 0 1919 0 MODBLIV false 06116 11 P Radio/Intra/Periapical 6 Radio/Intra/Periapical 6 false false false 0 0 1919 0 MODBLIV false 06117 11 P Radio/Intra/Periapical 7 Radio/Intra/Periapical 7 false false false 0 0 1919 0 MODBLIV false 06118 11 P Radio/Intra/Periapical 8 Radio/Intra/Periapical 8 false false false 0 0 1919 0 MODBLIV false 06119 11 P Radio/Intra/Periapical 9 Radio/Intra/Periapical 9 false false false 0 0 1919 0 MODBLIV false 06120 11 P Radio/Intra/Periapical 10 Radio/Intra/Periapical 10 false false false 0 0 1919 0 MODBLIV false 06121 11 P Radio/Intra/Periapical 11 Radio/Intra/Periapical 11 false false false 0 0 1919 0 MODBLIV false 06122 11 P Radio/Intra/Periapical 12 Radio/Intra/Periapical 12 false false false 0 0 1919 0 MODBLIV false 06123 11 P Radio/Intra/Periapical 13 Radio/Intra/Periapical 13 false false false 0 0 1919 0 MODBLIV false 06124 11 P Radio/Intra/Periapical 14 Radio/Intra/Periapical 14 false false false 0 0 1919 0 MODBLIV false 06125 11 P Radio/Intra/Periapical 15 Radio/Intra/Periapical 15 false false false 0 0 1919 0 MODBLIV false 06131 11 P Radio/Occlusal 1 Film Radio/Occlusal 1 Film false false false 0 0 1919 0 MODBLIV false 06132 11 P Radio/Occlusal 2 Films Radio/Occlusal 2 Films false false false 0 0 1919 0 MODBLIV false 06133 11 P Radio/Occlusal 3 Films Radio/Occlusal 3 Films false false false 0 0 1919 0 MODBLIV false 06134 11 P Radio/Occlusal 4 Films Radio/Occlusal 4 Films false false false 0 0 1919 0 MODBLIV false 06135 11 P Radio/Occlusal 5 Films Radio/Occlusal 5 Films false false false 0 0 1919 0 MODBLIV false 06136 11 P Radio/Occlusal 6 Films Radio/Occlusal 6 Films false false false 0 0 1919 0 MODBLIV false 06141 11 P Radio/Intra/Bitewing 1 Fi Radio/Intra/Bitewing 1 Fi false false false 0 0 1919 0 MODBLIV false 06142 11 P Radio/Intra/Bitewing 2 Fi Radio/Intra/Bitewing 2 Fi false false false 0 0 1919 0 MODBLIV false 06143 11 P Radio/Intra/Bitewing 3 Fi Radio/Intra/Bitewing 3 Fi false false false 0 0 1919 0 MODBLIV false 06144 11 P Radio/Intra/Bitewing 4 Fi Radio/Intra/Bitewing 4 Fi false false false 0 0 1919 0 MODBLIV false 06145 11 P Radio/Intra/Bitewing 5 Fi Radio/Intra/Bitewing 5 Fi false false false 0 0 1919 0 MODBLIV false 06146 11 P Radio/Intra/Bitewing 6 Fi Radio/Intra/Bitewing 6 Fi false false false 0 0 1919 0 MODBLIV false 06201 11 P Radio/Extraoral/ 1 Film Radio/Extraoral/ 1 Film false false false 0 0 1919 0 MODBLIV false 06202 11 P Radio/Extraoral/ 2 Films Radio/Extraoral/ 2 Films false false false 0 0 1919 0 MODBLIV false 06203 11 P Radio/Extraoral/ 3 Films Radio/Extraoral/ 3 Films false false false 0 0 1919 0 MODBLIV false 06204 11 P Radio/Extraoral/ 4 Films Radio/Extraoral/ 4 Films false false false 0 0 1919 0 MODBLIV false 06209 11 P Radio/Extraoral/Add Films Radio/Extraoral/Add Films false false false 0 0 1919 0 MODBLIV false 06301 11 P Radio/Skull/ 1 Film Radio/Skull/ 1 Film false false false 0 0 1919 0 MODBLIV false 06302 11 P Radio/Skull 2 Films Radio/Skull 2 Films false false false 0 0 1919 0 MODBLIV false 06303 11 P Radio/Skull 3 Films Radio/Skull 3 Films false false false 0 0 1919 0 MODBLIV false 06304 11 P Radio/Skull Sinus Exam Radio/Skull Sinus Exam false false false 0 0 1919 0 MODBLIV false 06309 11 P Radio/Skull Add Films Radio/Skull Add Films false false false 0 0 1919 0 MODBLIV false 06401 11 P Radio/Sialography 1 Film Radio/Sialography 1 Film false false false 0 0 1919 0 MODBLIV false 06402 11 P Radio/Sialography 2 Films Radio/Sialography 2 Films false false false 0 0 1919 0 MODBLIV false 06409 11 P Radio/Sialography Addfilm Radio/Sialography Addfilm false false false 0 0 1919 0 MODBLIV false 06411 11 P Radio/Dyes 1 Unit Radio/Dyes 1 Unit false false false 0 0 1919 0 MODBLIV false 06412 11 P Radio/Dyes 2 Units Radio/Dyes 2 Units false false false 0 0 1919 0 MODBLIV false 06419 11 P Radio/Dyes Add Units Radio/Dyes Add Units false false false 0 0 1919 0 MODBLIV false 06501 11 P Radio/Temporomand/1 Film Radio/Temporomand/1 Film false false false 0 0 1919 0 MODBLIV false 06502 11 P Radio/Temporomand/2 Film Radio/Temporomand/2 Film false false false 0 0 1919 0 MODBLIV false 06503 11 P Radio/Temporomand/3 Film Radio/Temporomand/3 Film false false false 0 0 1919 0 MODBLIV false 06504 11 P Radio/Temporomand/4 Film Radio/Temporomand/4 Film false false false 0 0 1919 0 MODBLIV false 06509 11 P Radio/Temporomand/Add Fil Radio/Temporomand/Add Fil false false false 0 0 1919 0 MODBLIV false 06511 11 P Arthography Procedure Arthography Procedure false false false 0 0 1919 0 MODBLIV false 06521 11 P Interpret/Artho/1 Unit Interpret/Artho/1 Unit false false false 0 0 1919 0 MODBLIV false 06529 11 P Interpret/Artho/Add Unit Interpret/Artho/Add Unit false false false 0 0 1919 0 MODBLIV false 06601 11 P Radio/Panoramic/ 1 Film Radio/Panoramic/ 1 Film false false false 0 0 1919 0 MODBLIV false 06701 11 P Radio/Cephalometric/1 Fil Radio/Cephalometric/1 Fil false false false 0 0 1919 0 MODBLIV false 06702 11 P Radio/Cephalometric/2 Fil Radio/Cephalometric/2 Fil false false false 0 0 1919 0 MODBLIV false 06703 11 P Radio/Cephalometric/3 Fil Radio/Cephalometric/3 Fil false false false 0 0 1919 0 MODBLIV false 06704 11 P Radio/Cephalometric/4 Fil Radio/Cephalometric/4 Fil false false false 0 0 1919 0 MODBLIV false 06709 11 P Radio/Cephalometric/Add Radio/Cephalometric/Add false false false 0 0 1919 0 MODBLIV false 06751 11 P Radio/Cepha/Trace&inter/1 Radio/Cepha/Trace&inter/1 false false false 0 0 1919 0 MODBLIV false 06752 11 P Radio/Cepha/Trace&inter/2 Radio/Cepha/Trace&inter/2 false false false 0 0 1919 0 MODBLIV false 06759 11 P Radio/Cepha/Trace&inte,Ad Radio/Cepha/Trace&inte,Ad false false false 0 0 1919 0 MODBLIV false 06800 11 P Radiographs, Computerized Axial Tomograms (CAT), Position Emission Tomography (PET), Magnetic Resonance Images(MRI) Interpretation (includes the production of a dadiographic report and may include image processing and measurements) Radiographs, Computerized Axial Tomograms (CAT), Position Emission Tomography (PET), Magnetic Resonance Images(MRI) Interpretation (includes the production of a dadiographic report and may include image processing and measurements) false false false 0 0 false 0 06810 11 P Radiographs, Computerized Axial Tomograms, Positron Emission Tomograms, Magnetic Resonance Images, Interpretation, Oral Radiologist Radiographs, Computerized Axial Tomograms, Positron Emission Tomograms, Magnetic Resonance Images, Interpretation, Oral Radiologist false false false 0 0 false 0 06811 11 P Radio/Inter/Oral Rad/1 Un Radio/Inter/Oral Rad/1 Un false false false 0 0 1919 0 MODBLIV false 06812 11 P Radio/Inter/Oral Rad/2 Un Radio/Inter/Oral Rad/2 Un false false false 0 0 1919 0 MODBLIV false 06817 11 P Radio/Inter/Oral Rad/ .5 Radio/Inter/Oral Rad/ .5 false false false 0 0 1919 0 MODBLIV false 06819 11 P Radio/Inter/Oral Rad/Add Radio/Inter/Oral Rad/Add false false false 0 0 1919 0 MODBLIV false 06820 11 P Radiographs, Computerized Axial Tomograms, Positron Emission Tomograms, Magnetic Resonance Images, Interpretation, Specialist Other than Oral Radiologist Radiographs, Computerized Axial Tomograms, Positron Emission Tomograms, Magnetic Resonance Images, Interpretation, Specialist Other than Oral Radiologist false false false 0 0 false 0 06821 11 P Radio/Inter/Specialist 1 Radio/Inter/Specialist 1 false false false 0 0 1919 0 MODBLIV false 06822 11 P Radio/Inter/Specialist 2 Radio/Inter/Specialist 2 false false false 0 0 1919 0 MODBLIV false 06827 11 P Radio/Inter/Specialist .5 Radio/Inter/Specialist .5 false false false 0 0 1919 0 MODBLIV false 06829 11 P Radio/Inter/Specialist Ad Radio/Inter/Specialist Ad false false false 0 0 1919 0 MODBLIV false 06830 11 P Radiographs, Computerized Axial Tomograms, Positron Emission Tomograms, Magnetic Resonance Images, Interpretation (when either the radiograph, CAT scan, PET scan, MRI scan, or the interpretation is received from another source) Radiographs, Computerized Axial Tomograms, Positron Emission Tomograms, Magnetic Resonance Images, Interpretation (when either the radiograph, CAT scan, PET scan, MRI scan, or the interpretation is received from another source) false false false 0 0 false 0 06831 11 P Radio/Interpretation/ 1 Radio/Interpretation/ 1 false false false 0 0 1919 0 MODBLIV false 06832 11 P Radio/Interpretation/ 2 Radio/Interpretation/ 2 false false false 0 0 1919 0 MODBLIV false 06837 11 P Radio/Interpretation/ .5 Radio/Interpretation/ .5 false false false 0 0 1919 0 MODBLIV false 06839 11 P Radio/Interpretation/ Add Radio/Interpretation/ Add false false false 0 0 1919 0 MODBLIV false 06911 11 P Radio/Duplication 1 Film Radio/Duplication 1 Film false false false 0 0 1919 0 MODBLIV false 06912 11 P Radio/Duplication 2 Films Radio/Duplication 2 Films false false false 0 0 1919 0 MODBLIV false 06913 11 P Radio/Duplication 3 Films Radio/Duplication 3 Films false false false 0 0 1919 0 MODBLIV false 06914 11 P Radio/Duplication 4 Films Radio/Duplication 4 Films false false false 0 0 1919 0 MODBLIV false 06915 11 P Radio/Duplication 5 Films Radio/Duplication 5 Films false false false 0 0 1919 0 MODBLIV false 06916 11 P Radio/Duplication 6 Films Radio/Duplication 6 Films false false false 0 0 1919 0 MODBLIV false 06917 11 P Radio/Duplication 7 Films Radio/Duplication 7 Films false false false 0 0 1919 0 MODBLIV false 06918 11 P Radio/Duplication 8 Films Radio/Duplication 8 Films false false false 0 0 1919 0 MODBLIV false 06919 11 P Radio/Duplication Add Fil Radio/Duplication Add Fil false false false 0 0 1919 0 MODBLIV false 06921 11 P Duplicate/Comp, Series 12 Duplicate/Comp, Series 12 false false false 0 0 1919 0 MODBLIV false 06922 11 P Duplicate/Comp,Series 13+ Duplicate/Comp,Series 13+ false false false 0 0 1919 0 MODBLIV false 06931 11 P Radio/Tomography/ 1 View Radio/Tomography/ 1 View false false false 0 0 1919 0 MODBLIV false 06932 11 P Radio/Tomography/ 2 Views Radio/Tomography/ 2 Views false false false 0 0 1919 0 MODBLIV false 06933 11 P Radio/Tomography/ 3 Views Radio/Tomography/ 3 Views false false false 0 0 1919 0 MODBLIV false 06934 11 P Radio/Tomography/ 4 Views Radio/Tomography/ 4 Views false false false 0 0 1919 0 MODBLIV false 06939 11 P Radio/Tomography/ Add Radio/Tomography/ Add false false false 0 0 1919 0 MODBLIV false 06941 11 P Radio/Hand&wrist (tech) Radio/Hand&wrist (tech) false false false 0 0 1919 0 MODBLIV false 07110 11 P Removal 1st Tooth,Uncomp. Removal 1st Tooth,Uncomp. false false false 0 0 1919 MODBLIV false 07120 11 P Removal,Additional Tooth Removal,Additional Tooth false false false 0 0 1919 MODBLIV false 07200 11 P Surgery Req. Muco. Flap Surgery Req. Muco. Flap false false false 0 0 1919 MODBLIV false 07220 11 P Soft Tissue Impaction Soft Tissue Impaction false false false 0 0 1919 MODBLIV false 07230 11 P Semi-Oss. Unerupted Impac Semi-Oss. Unerupted Impac false false false 0 0 1919 MODBLIV false 07240 11 P Full Oss. Unerupted Impac Full Oss. Unerupted Impac false false false 0 0 1919 MODBLIV false 07250 11 P Root Removal-Require Flap Root Removal-Require Flap false false false 0 0 1919 MODBLIV false 07260 11 P Root Removal-Bone Covered Root Removal-Bone Covered false false false 0 0 1919 MODBLIV false 11001 12 P Prevent care Package - F- Prevent care Package - F- false false false 0 0 false 11002 12 P Prevent Care Package for Children no F- Prevent Care Package for Children no F- false false false 0 0 false 11003 12 P Exam Exam false false false 0 0 false 11101 12 P One Unit Polishing One Unit Polishing false false false 1 0 false 11102 12 P Prophy - Mixed Prophy - Mixed false false false 0 0 false 11103 12 P Prophy - Permanent Prophy - Permanent false false false 0 0 false 11107 12 P Polishing Polishing false false false 0 0 false 11109 12 P Polishing Add Time Over 2 Polishing Add Time Over 2 false false false 0 0 1919 MODBLIV false 11111 12 R Scaling - 1 U Scaling - 1 U false false false 1 0 false 11112 12 R Scaling - 2 U Scaling - 2 U false false false 1 0 false 11113 12 R Scaling - 3 U Scaling - 3 U false false false 1 0 false 11114 12 R Scaling - 4 U Scaling - 4 U false false false 1 0 false 11115 12 R Scaling - 5 U Scaling - 5 U false false false 1 0 false 11116 12 R Scaling - 6 U Scaling - 6 U false false false 1 0 false 11117 12 R Scaling - 1/2 U Scaling - 1/2 U false false false 1 0 false 11119 12 P Scaling - additional unit over six. Scaling - additional unit over six. false false false 1 0 false 11201 12 P Preven/Recall 1 Primary Preven/Recall 1 Primary false false false 0 0 1919 0 MODBLIV false 11202 12 P Preven/Recall 1 Mixed Preven/Recall 1 Mixed false false false 0 0 1919 0 MODBLIV false 11203 12 P Preven/Recall 1 Permanent Preven/Recall 1 Permanent false false false 0 0 1919 0 MODBLIV false 11301 12 P Preven/Recall 2 Primary Preven/Recall 2 Primary false false false 0 0 1919 0 MODBLIV false 11302 12 P Preven/Recall 2 Mixed Preven/Recall 2 Mixed false false false 0 0 1919 0 MODBLIV false 11303 12 P Preven/Recall 2 Permanent Preven/Recall 2 Permanent false false false 0 0 1919 0 MODBLIV false 11401 12 P Preven/Recall 3 Primary Preven/Recall 3 Primary false false false 0 0 1919 0 MODBLIV false 11402 12 P Preven/Recall 3 Mixed Preven/Recall 3 Mixed false false false 0 0 1919 0 MODBLIV false 11403 12 P Preven/Recall 3 Permanent Preven/Recall 3 Permanent false false false 0 0 1919 0 MODBLIV false 11501 12 P Preven/Recall 4 Primary Preven/Recall 4 Primary false false false 0 0 1919 0 MODBLIV false 11502 12 P Preven/Recall 4 Mixed Preven/Recall 4 Mixed false false false 0 0 1919 0 MODBLIV false 11503 12 P Preven/Recall 4 Permanent Preven/Recall 4 Permanent false false false 0 0 1919 0 MODBLIV false 12101 12 P Topical Fluoride Topical Fluoride false false false 1 0 false 12102 12 P Supervised Fluoride Trt Supervised Fluoride Trt false false false 1 0 false 12601 12 P Fluoride Max Arch Fluoride Max Arch true false false 0 0 false 12602 12 P Fluoride Mand Arch Fluoride Mand Arch true false false 0 0 false 12603 12 P Flouride Max + Mand Flouride Max + Mand true false false 0 0 false 12701 12 P Medicat/Custom Maxillary Medicat/Custom Maxillary false false false 0 0 1919 0 MODBLIV false 12702 12 P Medicat/Custom Mandibular Medicat/Custom Mandibular false false false 0 0 1919 0 MODBLIV false 13101 12 P Nutritional Consult - 1 U Nutritional Consult - 1 U false false false 0 0 false 13102 12 P Nutritional Counselling - Nutritional Counselling - false false false 0 0 1919 0 MODBLIV false 13103 12 P Nutritional Counselling - Nutritional Counselling - false false false 0 0 1919 0 MODBLIV false 13104 12 P Nutritional Counselling - Nutritional Counselling - false false false 0 0 1919 0 MODBLIV false 13109 12 P Nutritional Counselling - Nutritional Counselling - false false false 0 0 1919 0 MODBLIV false 13211 12 P Oral Hygiene Oral Hygiene false false false 0 0 false 13212 12 P Oral Hygiene Instruction Oral Hygiene Instruction false false false 0 0 1919 0 MODBLIV false 13213 12 P Oral Hygiene Instruction Oral Hygiene Instruction false false false 0 0 1919 0 MODBLIV false 13214 12 P Oral Hygiene Instruction Oral Hygiene Instruction false false false 0 0 1919 0 MODBLIV false 13217 12 P Oral Hygiene Instruction Oral Hygiene Instruction false false false 0 0 1919 MODBLIV false 13219 12 P Oral Hygiene Instruction Oral Hygiene Instruction false false false 0 0 1919 0 MODBLIV false 13221 12 P Ohi 1 Unit Ohi 1 Unit false false false 0 0 1919 0 MODBLIV false 13222 12 P Ohi 2 Units Ohi 2 Units false false false 0 0 1919 0 MODBLIV false 13223 12 P Ohi 3 Units Ohi 3 Units false false false 0 0 1919 0 MODBLIV false 13224 12 P Ohi 4 Units Ohi 4 Units false false false 0 0 1919 0 MODBLIV false 13227 12 P Ohi Half Unit Ohi Half Unit false false false 0 0 1919 0 MODBLIV false 13229 12 P Ohi Add. Ohi Add. false false false 0 0 1919 0 MODBLIV false 13231 12 P Oral Hygiene, Re-Instruct Oral Hygiene, Re-Instruct false false false 0 0 1919 0 MODBLIV false 13232 12 P Re-Instruction 2 Units Re-Instruction 2 Units false false false 0 0 1919 0 MODBLIV false 13237 12 P Re-Instruction .5 Unit Re-Instruction .5 Unit false false false 0 0 1919 MODBLIV false 13239 12 P Re-Instruction Add. Re-Instruction Add. false false false 0 0 1919 0 MODBLIV false 13241 12 P Ohi A/V 1 Unit Ohi A/V 1 Unit false false false 0 0 1919 0 MODBLIV false 13242 12 P Ohi A/V 2 Units Ohi A/V 2 Units false false false 0 0 1919 0 MODBLIV false 13247 12 P Ohi A/V .5 Unit Ohi A/V .5 Unit false false false 0 0 1919 MODBLIV false 13249 12 P Ohi A/V Add. Ohi A/V Add. false false false 0 0 1919 0 MODBLIV false 13301 12 B Finishing Restoration Polishing, Removal 1 Unit Finishing Restoration Polishing, Removal 1 unit false false false 0 0 false 13302 12 B Finishing Restoration Polishing, Removal 2 Units Finishing Restoration Polishing, Removal 2 Units false false false 0 0 13303 12 P Finishing Restorations - Finishing Restorations - false false true 0 0 1919 5 MODBLIV false 13304 12 P Finishing Restorations - Finishing Restorations - false false true 0 0 1919 5 MODBLIV false 13309 12 P Finishing Restorations - Finishing Restorations - false false true 0 0 1919 5 MODBLIV false 13401 12 P Sealant Sealant false true false 0 0 1818 0 false 13409 12 P Sealant - same quadrant Sealant - same quadrant false true false 0 0 1818 0 false 13411 12 P Prevent Rest Resin Prevent Rest Resin false true false 0 0 1919 0 false 13419 12 P Sealant w/ tooth preperation Sealant w/ tooth preperation false true false 0 0 1919 0 false 13501 12 B Protective Appliance adj - Preformed Protective Appliance adj - Preformed false false false 0 0 13502 12 B Protective Appliance adj - Processed Protective Appliance adj - Processed true false false 0 0 false 13601 12 P Topical Application 1 U Topical Application 1 U false false false 0 0 false 13602 12 P Topical Application 2 U Topical Application 2 U false false false 0 0 false 13609 12 P Topical Appl Add Unit Topical Appl Add Unit false false false 0 0 1919 MODBLIV false 13701 12 P Discing of Deciduous Teeth Discing of Deciduous Teeth false true false 0 0 1919 0 false 13702 12 B Disking of Deciduous Teeth - 2 units Disking of Deciduous Teeth - 2 units false false false 0 0 false 13703 12 B Disckng of Deciduous Teeth - 3 units Disking of Deciduous Teeth - 3 units false false false 0 0 false 13704 12 P Disking, Teeth 4 Units Disking, Teeth 4 Units false false false 0 0 1919 0 MODBLIV false 13709 12 B Disking of Deciduous Teeth - add unit Disking of Deciduous Teeth - add unit false false false 0 0 false 13801 12 B Recontouring of Natural Teeth for Aesthetic - 1 unit Recontouring of Natural Teeth for Aesthetic - 1 unit false false false 0 0 false 13809 12 B Recontouring of Natural Teeth for Aesthetic - add unit Recontouring of Natural Teeth for Aesthetic - add unit false false false 0 0 false 13901 12 B Recontouring Teeth for Functional - 1 unit Recontouring Teeth for Functional - 1 unit false false false 0 0 13909 12 B Recontouring Teeth for Functional - add unit Recontouring Teeth for Functional - add unit false false false 0 0 14101 12 P Appli, Removable, Control of Oral Habits, Max Appli, Removable, Control of Oral Habits, Max true false false 0 0 false 14102 12 P Appli, Removable, Control of Oral Habits, Mand Appli, Removable, Control of Oral Habits, Mand true false false 0 0 false 14103 12 P Appli, Removable, Control of Oral Habits, Max + Mand Appli, Removable, Control of Oral Habits, Max + Mand true false false 0 0 false 14201 12 P Appli, Fixed / Cemented, Control of Oral Habits, Max Appli, Fixed / Cemented, Control of Oral Habits, Max true false false 0 0 false 14202 12 P Appli, Fixed / Cemented, Control of Oral Habits, Mand Appli, Fixed / Cemented, Control of Oral Habits, Mand true false false 0 0 false 14301 12 P Control of Oral Habits, Misc Control of Oral Habits, Misc true false false 0 0 false 14311 12 P Myofunctional Therapy 1 U Myofunctional Therapy 1 U true false false 0 0 false 14312 12 P Myofunctional Therapy 2 U Myofunctional Therapy 2 U true false false 0 0 false 14319 12 P Myofunctional Therapy - Add U Myofunctional Therapy - Add U true false false 0 0 false 14321 12 P Control of Oral Habits, Direct Approach, Bonded 1U Control of Oral Habits, Direct Approach, Bonded 1U false false false 0 0 false 14322 12 P Control of Oral Habits, Direct Approach, Bonded 2 U Control of Oral Habits, Direct Approach, Bonded 2 U false false false 0 0 false 14329 12 P Control of Oral Habits, Direct Approach, Bonded 3 U Control of Oral Habits, Direct Approach, Bonded 3 U false false false 0 0 false 14401 12 P Appli, Control of Oral Habits - adj, repair, mainten 1 U Appli, Control of Oral Habits - adj, repair, mainten 1 U true false false 0 0 false 14402 12 P Appli, Control of Oral Habits - adj,repair, maint 2 U Appli, Control of Oral Habits - adj,repair, mainten 2 U true false false 0 0 false 14403 12 P Appliances,Adjust,Rep.,Ma Appliances,Adjust,Rep.,Ma false false false 0 0 1919 0 MODBLIV false 14409 12 P Appliances,Adjust,Rep.,Ma Appliances,Adjust,Rep.,Ma false false false 0 0 1919 0 MODBLIV false 14501 12 P Mouth Guards Preformed Mouth Guards Preformed false false false 0 0 false 14502 12 P Mouth Guards Processed Mouth Guards Processed true false false 0 0 false 14611 12 P Appli Perio - Max Appli Perio - Max true false false 0 0 false 14612 12 P Appli Perio - Mand Appli Perio - Mand true false false 0 0 false 14621 12 P Appli, Mainten, Adj, Repair 1 U Appli Mainten, Adj, Repair 1 U true false false 0 0 false 14622 12 P Appli, Mainten, Adj, Repair 2 U Appli, Mainten, Adj, Repair 2 U true false false 0 0 false 14623 12 P Appli, Mainten, Adj, Repair 3 U Appli, Mainten, Adj, Repair 3 U true false false 0 0 false 14629 12 P Appli, Mainten, Adj, Repair - Add U Appli, Mainten, Adj, Repair - Add U true false false 0 0 false 14631 12 P Appli, Perio Reline - Direct Appli, Perio Reline - Direct false false false 0 0 false 14632 12 P Periodontal, Reline, Proc Periodontal, Reline, Proc false false false 0 0 1919 0 MODBLIV false 14711 12 P Appli, TMJ, Diag - Max Appli, TMJ, Diag - Max true false false 0 0 false 14712 12 P Appli, TMJ, Diag - Mand Appli, TMJ, Diag - Mand true false false 0 0 false 14721 12 P Appli, TMJ Intra Repositioning - Max Appli, TMJ Intra Repositioning - Max true false false 0 0 false 14722 12 P Appli, TMJ Intra Repositioning - Mand Appli, TMJ Intra Repositioning - Mand true false false 0 0 false 14731 12 P Appli, TMJ, Perio, Mainten, Adj, Repair 1 U Appli, TMJ, Perio, Mainten, Adj, Repair 1 U true false false 0 0 false 14732 12 P Appli, TMJ, Perio, Mainten, Adj, Repair 2 U Appli, TMJ, Perio, Mainten, Adj, Repair 2 U true false false 0 0 false 14733 12 P Tmj, Periodic Maintenance Tmj, Periodic Maintenance false false false 0 0 1919 0 MODBLIV false 14739 12 P Tmj, Periodic Maintenance Tmj, Periodic Maintenance false false false 0 0 1919 0 MODBLIV false 14741 12 P Appli, TMJ, Reline - Direct Appli, TMJ, Reline - Direct false false false 0 0 false 14742 12 P Tmj - Reline, Processed Tmj - Reline, Processed false false false 0 0 1919 0 MODBLIV false 14751 12 P Appl/Tmj/Diag/Insert/Max Appl/Tmj/Diag/Insert/Max false false false 0 0 1919 0 MODBLIV false 14752 12 P Appl/Tmj/Diag/Insert/Mand Appl/Tmj/Diag/Insert/Mand false false false 0 0 1919 0 MODBLIV false 14761 12 P Appl/Tmj/Reposition/Max Appl/Tmj/Reposition/Max false false false 0 0 1919 0 MODBLIV false 14762 12 P Appl/Tmj/Reposition/Mand Appl/Tmj/Reposition/Mand false false false 0 0 1919 0 MODBLIV false 14771 12 P Appl/Tmj/Main/Adj/Rep/1 Appl/Tmj/Main/Adj/Rep/1 false false false 0 0 1919 0 MODBLIV false 14772 12 P Appl/Tmj/Main/Adj/Rep/2 Appl/Tmj/Main/Adj/Rep/2 false false false 0 0 1919 0 MODBLIV false 14773 12 P Appl/Tmj/Main/Adj/Rep/3 Appl/Tmj/Main/Adj/Rep/3 false false false 0 0 1919 0 MODBLIV false 14779 12 P Appl/Tmj/Main/Adj/Rep/Add Appl/Tmj/Main/Adj/Rep/Add false false false 0 0 1919 0 MODBLIV false 14781 12 P Appl/Tmj/Reline, Direct Appl/Tmj/Reline, Direct false false false 0 0 1919 0 MODBLIV false 14782 12 P Appl/Tmj/Reline,Processed Appl/Tmj/Reline,Processed false false false 0 0 1919 0 MODBLIV false 14801 12 P Appl/Myo/Pain/Syn/Max Appl/Myo/Pain/Syn/Max false false false 0 0 1919 0 MODBLIV false 14802 12 P Appl/Myo/Pain/Syn/Mand Appl/Myo/Pain/Syn/Mand false false false 0 0 1919 0 MODBLIV false 14811 12 P Myofascial Pain Dysfunction Syndrome - Max Myofascial Pain Dysfunction Syndrome - Max true false false 0 0 false 14812 12 P Myofascial Pain Dysfunction Syndrome - Mand Myofascial Pain Dysfunction Syndrome - Mand true false false 0 0 false 14813 12 P Myofacial Pain Syndrome - Myofacial Pain Syndrome - false false false 0 0 1919 0 MODBLIV false 14819 12 P Myofacial Pain Syndrome Myofacial Pain Syndrome false false false 0 0 1919 0 MODBLIV false 14820 12 P Myofacial Pain Syndrome Myofacial Pain Syndrome false false false 0 0 1919 0 MODBLIV false 14821 12 P Myofascial Pain Dysfunction Syndrome, Perio, Mainten, Adj, Repair 1 Unit Myofascial Pain Dysfunction Syndrome, Perio, Mainten, Adj, Repair 1 Unit true false false 0 0 false 14822 12 P Myofascial Pain Dysfunction Syndrome, Perio, Mainten, Adj, Repair 2 Units Myofascial Pain Dysfunction Syndrome, Perio, Mainten, Adj, Repair 2 Units true false false 0 0 false 14823 12 P Mps, Periodic Maintenanc Mps, Periodic Maintenanc false false false 0 0 1919 0 MODBLIV false 14824 12 P Appliance, Myofacial Pain, Periodic, Adjust and Repairs 4 units Appliance, Myofacial Pain, Periodic, Adjust and Repairs 4 units false false false 0 4.0000 false 0 14829 12 P Mps, Periodic Maintenance Mps, Periodic Maintenance false false false 0 0 1919 0 MODBLIV false 14831 12 P Myofascial Pain Dysfunction Syndrome, Relines - Direct Myofascial Pain Dysfunction Syndrome, Relines - Direct true false false 0 0 false 14832 12 P Appl/M.P.D.S/Reline Proce Appl/M.P.D.S/Reline Proce false false false 0 0 1919 0 MODBLIV false 14841 12 P Appl/M.P.D.S/Max, Imp Sup Appl/M.P.D.S/Max, Imp Sup false false false 0 0 1919 0 MODBLIV false 14842 12 P Appl/M.P.D.S/Mand,Imp Sup Appl/M.P.D.S/Mand,Imp Sup false false false 0 0 1919 0 MODBLIV false 14851 12 P Appl/M.P.D.S/Main,Adj/Rep Appl/M.P.D.S/Main,Adj/Rep false false false 0 0 1919 0 MODBLIV false 14852 12 P Appl/M.P.D.S/Main,Adj/Rep Appl/M.P.D.S/Main,Adj/Rep false false false 0 0 1919 0 MODBLIV false 14853 12 P Appl/M.P.D.S/Main,Adj/Rep Appl/M.P.D.S/Main,Adj/Rep false false false 0 0 1919 0 MODBLIV false 14859 12 P Appl/M.P.D.S/Main,Adj/Rep Appl/M.P.D.S/Main,Adj/Rep false false false 0 0 1919 0 MODBLIV false 14861 12 P Appl/M.P.D.S/Reline Direc Appl/M.P.D.S/Reline Direc false false false 0 0 1919 0 MODBLIV false 14862 12 P Appl/M.P.D.S/Reline Proce Appl/M.P.D.S/Reline Proce false false false 0 0 1919 0 MODBLIV false 15101 12 P Unilateral Spacer Unilateral Spacer true true false 0 3 1218 0 false 15102 12 P Unilateral Spacer w/ Intra - Alveolar Unilateral Spacer w/ Intra - Alveolar true true false 0 3 0118 0 false 15103 12 P Bilateral Spacer Bilateral Spacer true true false 0 3 1218 0 false 15104 12 P Bilateral Spacer w/ Teeth Attach Bilateral Spacer w/ Teeth Attach true false false 0 0 false 15105 12 P Fixed Bilateral, Tubes and Wires Fixed Bilateral, Tubes and Wires true true false 0 0 1919 0 false 15201 12 P Stainless Steel Crown - Fixed Stainless Steel Crown - Fixed true false false 0 0 false 15202 12 P Stainless Steel Crown - Fixed, w/ Attach Stainless Steel Crown - Fixed, w/ Attach true false false 0 0 false 15301 12 P Cast Type, Fixed Cast Type, Fixed false false false 0 0 1919 0 MODBLIV false 15302 12 P Cast Type, Fixed, With I Cast Type, Fixed, With I false false false 0 0 1919 0 MODBLIV false 15401 12 P Bilateral Clasps, Retaing Wires Bilateral Clasps, Retaing Wires true false false 0 0 false 15402 12 P Bilateral Clasps, Retaing Wires W/ Teeth Bilateral Clasps, Retaing Wires W/ Teeth true false false 0 0 false 15403 12 P No clasps No clasps true false false 0 0 false 15501 12 P Bond, Pontic Type Bond, Pontic Type true false false 0 0 false 15601 12 P Adj / Recem after 30 day from insertion Adj / Recem after 30 day from insertion false true false 0 3 1218 0 false 15602 12 P addtion of Clasps / Activating Wires addtion of Clasps / Activating Wires true false false 0 0 false 15603 12 P Repair / Recementation Repair / Recementation true true false 0 3 1218 0 false 15604 12 P Removal of Fixed Appli by 2nd Doc Removal of Fixed Appli by 2nd Doc false false false 0 0 false 16001 12 P Anatomic Mod. One Unit Anatomic Mod. One Unit false false false 0 0 1919 0 MODBLIV false 16002 12 P Anatomic Mod. Two Units Anatomic Mod. Two Units false false false 0 0 1919 0 MODBLIV false 16009 12 P Anatomic Mod. Ea. Addtl. Anatomic Mod. Ea. Addtl. false false false 0 0 1919 0 MODBLIV false 16101 12 P Finishing Restore - 1 U Finishing Restore - 1 U false false false 0 0 false 16102 12 P Finishing Reste - 2 U Finishing Restore - 2 U false false false 0 0 false 16103 12 P Finishing Restorations - Finishing Restorations - false false false 0 0 1919 0 MODBLIV false 16104 12 P Finishing Restorations - Finishing Restorations - false false false 0 0 1919 0 MODBLIV false 16109 12 P Finishing Restorations - Finishing Restorations - false false false 0 0 1919 0 MODBLIV false 16201 12 P Disking, Interprox - 1 U Disking, Interprox - 1 U false false false 0 0 false 16202 12 P Disking, Interprox - 2 U Disking, Interprox - 2 U false false false 0 0 false 16203 12 P Disking, Interprox - 3 U Disking, Interprox - 3 U false false false 0 0 false 16204 12 P Disking/Interproximal 4 U Disking/Interproximal 4 U false false false 0 0 1919 0 MODBLIV false 16209 12 P Disking Interprox - Add U Disking Interprox - Add U false false false 0 0 false 16301 12 P Aesthetic Recontouring Teeth - 1 U Aesthetic Recontouring Teeth - 1 U false false false 0 0 false 16309 12 P Aesthetic Recontouring Teeth - Add U Aesthetic Recontouring Teeth - Add U false false false 0 0 false 16401 12 P Recontouring - Functional Reasons 1 Unit Recontouring - Functional Reasons 1 Unit false false false 0 0 false 16402 12 P Recontour /Each Addtl. Un Recontour /Each Addtl. Un false false false 0 0 1919 0 MODBLIV false 16409 12 P Recontouring - Functional Reasons Add Unit Recontouring - Functional Reasons Add Unit false false false 0 0 false 16511 12 P Occlusal Adjust / Equilibration - 1 Unit Occlusal Adjust/ Equilibration - 1 Unit false false false 0 0 false 16512 12 P Occlusal Adjust / Equilibration - 2 Units Occlusal Adjust / Equilibration - 2 Units false false false 0 0 false 16513 12 P Occlusal Adjust / Equilibration - 3 Units Occlusal Adjust / Equilibration - 3 Units false false false 0 0 false 16514 12 P Occlusal Adjust / Equilibration - 4 Units Occlusal Adjust / Equilibration - 4 Units false false false 0 0 false 16517 12 P Occlusal Adjust / Equilibration - 0.5 Unit Occlusal Adjust / Equilibration - 0.5 Unit false false false 0 0 false 16519 12 P Occlusal Adjust/ Equilibration - Add Units over 4 Occlusal Adjust/ Equilibration - Add Units over 4 false false false 0 0 false 16601 12 P Finish Restor. One Unit Finish Restor. One Unit false false false 0 0 1919 0 MODBLIV false 16602 12 P Finish Restor. Two Units Finish Restor. Two Units false false false 0 0 1919 0 MODBLIV false 18000 12 P Cert. Specialist Services Cert. Specialist Services false false false 0 0 1919 MODBLIV false 20000 13 B false false false 0 0 1919 0 MODBLIV 0 false 0 20111 13 B Removal Caries, 1st Tooth Removal Caries, 1st Tooth false true false 0 0 1818 0 false 20119 13 B Removal Caries, same quadrant Removal Caries, same quadrant true true false 0 0 1919 0 false 20121 13 B Removal Caries / band, 1St Tooth Removal Caries / band, 1St Tooth true true false 0 0 1919 0 false 20129 13 B Removal Caries / band, same quadrant Removal Caries / band, same quadrant true true false 0 0 1919 0 false 20131 13 B Trauma Control 1st Tooth Trauma Control 1st Tooth true true false 0 0 1818 0 false 20139 13 B Trauma Control / same quadrant Trauma Control / same quadrant true true false 0 0 1818 0 false 20141 13 B Direct Pulp Cap Direct Pulp Cap true true false 0 0 1818 0 false 20149 13 B Pulp Capping, Direct Pulp Capping, Direct false false false 0 0 1919 MODBLIV false 21101 13 B Primary Ag / Comp 1S Primary Ag / Comp 1S false true true 0 0 5815 1 MODBLIV 0 false 21102 13 B Primary Ag / Comp 2S Primary Ag / Comp 2S false true true 0 0 5815 2 MODBLIV 0 false 21103 13 B Primary Ag / Comp 3S Primary Ag / Comp 3S false true true 0 0 5815 3 MODBLIV 0 false 21104 13 B Primary Ag / Comp 4S Primary Ag / Comp 4S false true true 0 0 5815 4 MODBLIV 0 false 21105 13 B Primary Ag / Comp 5S Primary Ag / Comp 5S false true true 0 0 5815 5 MODBLIV 0 false 21111 13 B Primary Ag 1S Primary Ag 1S false true true 0 0 5815 1 MODBLIV 0 false 21112 13 B Primary Ag 2S Primary Ag 2S false true true 0 0 5815 2 MODBLIV 0 false 21113 13 B Primary Ag 3S Primary Ag 3S false true true 0 0 5815 3 MODBLIV 0 false 21114 13 B Primary Ag 4S Primary Ag 4S false true true 0 0 5815 4 MODBLIV 0 false 21115 13 B Primary Ag 5S Primary Ag 5S false true true 0 0 5815 5 MODBLIV 0 false 21121 13 B Primary Ag / Bonded 1S Primary Ag / Bonded 1S false true true 0 0 5815 1 MODBLIV 0 false 21122 13 B Primary Ag / Bonded 2S Primary Ag / Bonded 2S false true true 0 0 5815 2 MODBLIV 0 false 21123 13 B Primary Ag / Bonded 3S Primary Ag / Bonded 3S false true true 0 0 5815 3 MODBLIV 0 false 21124 13 B Primary Ag / Bonded 4S Primary Ag / Bonded 4S false true true 0 0 5815 4 MODBLIV 0 false 21125 13 B Primary Ag / Bonded 5S Primary Ag / Bonded 5S false true true 0 0 5815 5 MODBLIV 0 false 21211 13 B Permanent Ant / Bicus Ag 1S Permanent Ant / Bicus Ag 1S false true true 0 0 1415 1 MODBLIV 0 false 21212 13 B Permanent Ant / Bicus Ag 2S Permanent Ant / Bicus Ag 2S false true true 0 0 1415 2 MODBLIV 0 false 21213 13 B Permanent Ant / Bicus Ag 3S Permanent Ant / Bicus Ag 3S false true true 0 0 1415 3 MODBLIV 0 false 21214 13 B Permanent Ant / Bicus Ag 4S Permanent Ant / Bicus Ag 4S false true true 0 0 1415 4 MODBLIV 0 false 21215 13 B Permanent Ant / Bicus Ag 5S Permanent Ant / Bicus Ag 5S false true true 0 0 1415 5 MODBLIV 0 false 21221 13 B Permanent Molar Ag 1S Permanent Molar Ag 1S false true true 0 0 1468 1 MODBLIV 0 false 21222 13 B Permanent Molar Ag 2S Permanent Molar Ag 2S false true true 0 0 1468 2 MODBLIV 0 false 21223 13 B Permanent Molar Ag 3S Permanent Molar Ag 3S false true true 0 0 1468 3 MODBLIV 0 false 21224 13 B Permanent Molar Ag 4S Permanent Molar Ag 4S false true true 0 0 1468 4 MODBLIV 0 false 21225 13 B Permanent Molar Ag 5S Permanent Molar Ag 5S false true true 0 0 1468 5 MODBLIV 0 false 21231 13 B Permanent Ant / Bicus Ag Bonded 1S Permanent Ant / Bicus Ag Bonded 1S false true true 0 0 1435 1 MODBLIV 0 false 21232 13 B Permanent Ant / Bicus Ag Bonded 2S Permanent Ant / Bicus Ag Bonded 2S false true true 0 0 1435 2 MODBLIV 0 false 21233 13 B Permanent Ant / Bicus Ag Bonded 3S Permanent Ant / Bicus Ag Bonded 3S false true true 0 0 1435 3 MODBLIV 0 false 21234 13 B Permanent Ant / Bicus Ag Bonded 4S Permanent Ant / Bicus Ag Bonded 4S false true true 0 0 1435 4 MODBLIV 0 false 21235 13 B Permanent Ant / Bicus Ag Bonded 5S Permanent Ant / Bicus Ag Bonded 5S false true true 0 0 1435 5 MODBLIV 0 false 21241 13 B Permanent Molar Ag Bonded 1S Permanent Molar Ag Bonded 1S false true true 0 0 1468 1 MODBLIV 0 false 21242 13 B Permanent Molar Ag Bonded 2S Permanent Molar Ag Bonded 2S false true true 0 0 1468 2 MODBLIV 0 false 21243 13 B Permanent Molar Ag Bonded 3S Permanent Molar Ag Bonded 3S false true true 0 0 1468 3 MODBLIV 0 false 21244 13 B Permanent Molar Ag Bonded 4S Permanent Molar Ag Bonded 4S false true true 0 0 1468 4 MODBLIV 0 false 21245 13 B Permanent Molar Ag Bonded 5S Permanent Molar Ag Bonded 5S false true true 0 0 1468 5 MODBLIV 0 false 21301 13 M Ag Core Ag Core false true false 0 0 1418 0 false 21302 13 M Ag Bonded Core Ag Bonded Core false false false 0 0 false 21401 13 B 1 Retentive Pin 1 Retentive Pin false true false 0 0 1418 0 false 21402 13 B 2 Retentive Pins 2 Retentive Pins false true false 0 0 1418 0 false 21403 13 B 3 Retentive Pins 3 Retentive Pins false true false 0 0 1418 0 false 21404 13 B 4 Retentive Pins 4 Retentive Pins false true false 0 0 1418 0 false 21405 13 B 5 Rententive Pins & more 5 Rententive Pins & more false true false 0 0 1418 0 false 21501 13 B Rest. Support Existing Rest. Support Existing false false false 0 0 1919 0 MODBLIV false 22201 13 B SSC Primary Anterior SSC Primary Anterior false true false 0 0 5813 0 false 22202 13 B SSC Primary Anterior - Open Face SSC Primary Anterior - Open Face false true false 0 0 5813 0 false 22211 13 B SSC Primary Posterior SSC Primary Posterior false true false 0 0 5845 0 false 22212 13 B SSC Primary Posterior - Open Face SSC Primary Posterior - Open Face false true false 0 0 5845 0 false 22301 13 B SSC Permanent Anterior SSC Permanent Anterior false true false 0 0 1418 0 false 22302 13 B Stainless Steel Crown,Per Stainless Steel Crown,Per false false false 0 0 1919 MODBLIV false 22311 13 B SSC Permanent Posterior SSC Permanent Posterior false true false 0 0 1418 0 false 22312 13 B Stainless Steel Crown-Per Stainless Steel Crown-Per false false false 0 0 1919 MODBLIV false 22401 13 B Plasic Primary Anterior Plasic Primary Anterior false true false 0 0 5813 0 false 22411 13 B Plastic Primary Posterior Plastic Primary Posterior false true false 0 0 5856 0 false 22501 13 B Plastic Permanent Anterior Plastic Permanent Anterior false true false 0 0 1413 0 false 22511 13 B Plastic Permanent Posterior Plastic Permanent Posterior false true false 0 0 1468 0 false 23101 13 B Permanent Ant non bonded 1S Permanent Ant non bonded 1S false true true 0 0 1413 1 MODBLIV 0 false 23102 13 B Permanent Ant non bonded 2S Permanent Ant non bonded 2S false true true 0 0 1413 2 MODBLIV 0 false 23103 13 B Permanent Ant non bonded 3S Permanent Ant non bonded 3S false true true 0 0 1413 3 MODBLIV 0 false 23104 13 B Permanent Ant non bonded 4S Permanent Ant non bonded 4S false true true 0 0 1413 4 MODBLIV 0 false 23105 13 B Permanent Ant non bonded 5S Permanent Ant non bonded 5S false true true 0 0 1413 5 MODBLIV 0 false 23111 13 B Permanent Ant Bonded & Each 1S Permanent Ant Bonded & Each 1S false true true 0 0 1413 1 MODBLIV 0 false 23112 13 B Permanent Ant Bonded & Each 2S Permanent Ant Bonded & Each 2S false true true 0 0 1413 2 MODBLIV 0 false 23113 13 B Permanent Ant Bonded & Each 3S Permanent Ant Bonded & Each 3S false true true 0 0 1413 3 MODBLIV 0 false 23114 13 B Permanent Ant Bonded & Each 4S Permanent Ant Bonded & Each 4S false true true 0 0 1413 4 MODBLIV 0 false 23115 13 B Permanent Ant Bonded & Each 5S Permanent Ant Bonded & Each 5S false true true 0 0 1413 5 MODBLIV 0 false 23121 13 M Prefabricated - Bonded Prefabricated - Bonded false false false 0 0 false 23122 13 M Non Prefabricated - Bonded Non Prefabricated - Bonded false true false 0 0 1418 0 false 23123 13 M Diastema Closure, Interproximal only - Bonded Diastema Closure, Interproximal only - Bonded false true false 0 0 1418 0 false 23211 13 B Permanent Biscuspid Non Bonded 1S Permanent Biscuspid Non Bonded 1S false true true 0 0 1445 1 MODBLIV 0 false 23212 13 B Permanent Biscuspid Non Bonded 2S Permanent Biscuspid Non Bonded 2S false true true 0 0 1445 2 MODBLIV 0 false 23213 13 B Permanent Biscuspid Non Bonded 3S Permanent Biscuspid Non Bonded 3S false true true 0 0 1445 3 MODBLIV 0 false 23214 13 B Permanent Biscuspid Non Bonded 4S Permanent Biscuspid Non Bonded 4S false true true 0 0 1445 4 MODBLIV 0 false 23215 13 B Permanent Biscuspid Non Bonded 5S Permanent Biscuspid Non Bonded 5S false true true 0 0 1445 5 MODBLIV 0 false 23221 13 B Permanent Molar Non Bonded 1S Permanent Molar Non Bonded 1S false true true 0 0 1468 1 MODBLIV 0 false 23222 13 B Permanent Molar Non Bonded 2S Permanent Molar Non Bonded 2S false true true 0 0 1468 2 MODBLIV 0 false 23223 13 B Permanent Molar Non Bonded 3S Permanent Molar Non Bonded 3S false true true 0 0 1468 3 MODBLIV 0 false 23224 13 B Permanent Molar Non Bonded 4S Permanent Molar Non Bonded 4S false true true 0 0 1468 4 MODBLIV 0 false 23225 13 B Permanent Molar Non Bonded 5S Permanent Molar Non Bonded 5S false true true 0 0 1468 5 MODBLIV 0 false 23233 13 B Perm Molars/3 Surfaces Perm Molars/3 Surfaces false false false 0 0 1919 MODBLIV false 23311 13 B Permanent Bicuspid Bonded 1S Permanent Bicuspid Bonded 1S false true true 0 0 1445 1 MODBLIV 0 false 23312 13 B Permanent Bicuspid Bonded 2S Permanent Bicuspid Bonded 2S false true true 0 0 1445 2 MODBLIV 0 false 23313 13 B Permanent Bicuspid Bonded 3S Permanent Bicuspid Bonded 3S false true true 0 0 1445 3 MODBLIV 0 false 23314 13 B Permanent Bicuspid Bonded 4S Permanent Bicuspid Bonded 4S false true true 0 0 1445 4 MODBLIV 0 false 23315 13 B Permanent Bicuspid Bonded 5S Permanent Bicuspid Bonded 5S false true true 0 0 1445 5 MODBLIV 0 false 23321 13 B Permanent Molar Bonded 1S Permanent Molar Bonded 1S false true true 0 0 1468 1 MODBLIV 0 false 23322 13 B Permanent Molar Bonded 2S Permanent Molar Bonded 2S false true true 0 0 1468 2 MODBLIV 0 false 23323 13 B Permanent Molar Bonded 3S Permanent Molar Bonded 3S false true true 0 0 1468 3 MODBLIV 0 false 23324 13 B Permanent Molar Bonded 4S Permanent Molar Bonded 4S false true true 0 0 1468 4 MODBLIV 0 false 23325 13 B Permanent Molar Bonded 5S Permanent Molar Bonded 5S false true true 0 0 1468 5 MODBLIV 0 false 23401 13 B Primary Anterior Non Bonded 1S Primary Anterior Non Bonded 1S false true true 0 0 5813 1 MODBLIV 0 false 23402 13 B Primary Anterior Non Bonded 2S Primary Anterior Non Bonded 2S false true true 0 0 5813 2 MODBLIV 0 false 23403 13 B Primary Anterior Non Bonded 3S Primary Anterior Non Bonded 3S false true true 0 0 5813 3 MODBLIV 0 false 23404 13 B Primary Anterior Non Bonded 4S Primary Anterior Non Bonded 4S false true true 0 0 5813 4 MODBLIV 0 false 23405 13 B Primary Anterior Non Bonded 5S Primary Anterior Non Bonded 5S false true true 0 0 5813 5 MODBLIV 0 false 23411 13 B Primary Anterior Bonded 1S Primary Anterior Bonded 1S false true true 0 0 5813 1 MODBLIV 0 false 23412 13 B Primary Anterior Bonded 2S Primary Anterior Bonded 2S false true true 0 0 5813 2 MODBLIV 0 false 23413 13 B Primary Anterior Bonded 3S Primary Anterior Bonded 3S false true true 0 0 5813 3 MODBLIV 0 false 23414 13 B Primary Anterior Bonded 4S Primary Anterior Bonded 4S false true true 0 0 5813 4 MODBLIV 0 false 23415 13 B Primary Anterior Bonded 5S Primary Anterior Bonded 5S false true true 0 0 5813 5 MODBLIV 0 false 23501 13 B Primary Posterior Non Bonded 1S Primary Posterior Non Bonded 1S false true true 0 0 5815 1 MODBLIV 0 false 23502 13 B Primary Posterior Non Bonded 2S Primary Posterior Non Bonded 2S false true true 0 0 5815 2 MODBLIV 0 false 23503 13 B Primary Posterior Non Bonded 3S Primary Posterior Non Bonded 3S false true true 0 0 5815 3 MODBLIV 0 false 23504 13 B Primary Posterior Non Bonded 4S Primary Posterior Non Bonded 4S false true true 0 0 5815 4 MODBLIV 0 false 23505 13 B Primary Posterior Non Bonded 5S Primary Posterior Non Bonded 5S false true true 0 0 5815 5 MODBLIV 0 false 23511 13 B Primary Posterior Bonded 1S Primary Posterior Bonded 1S false true true 0 0 5815 1 MODBLIV 0 false 23512 13 B Primary Posterior Bonded 2S Primary Posterior Bonded 2S false true true 0 0 5815 2 MODBLIV 0 false 23513 13 B Primary Posterior Bonded 3S Primary Posterior Bonded 3S false true true 0 0 5815 3 MODBLIV 0 false 23514 13 B Primary Posterior Bonded 4S Primary Posterior Bonded 4S false true true 0 0 5815 4 MODBLIV 0 false 23515 13 B Primary Posterior Bonded 5S Primary Posterior Bonded 5S false true true 0 0 5815 5 MODBLIV 0 false 23601 13 M Composite Core Non-Bonded Composite Core Non-Bonded false true false 0 0 1818 0 false 23602 13 M Composite Core Bonded Composite Core Bonded false true false 0 0 1919 0 false 24000 13 M Gold Folis Gold Folis false true false 0 0 1919 0 false 24101 13 M Gold Foil Anteterior Class I Gold Foil Anteterior Class I false true false 0 0 1413 0 false 24102 13 M Gold Foil Anterior Class Iii Gold Foil Anterior Class Iii false true false 0 0 1413 0 false 24103 13 M Gold Foil Anterior Class V Gold Foil Anterior Class V false true false 0 0 1413 0 false 24104 13 M Gold Foil Antetior Class Iv Gold Foil Antetior Class Iv false true false 0 0 1413 0 false 24201 13 M Gold Foil PosteriorClass I Gold Foil PosteriorClass I false true false 0 0 1468 0 false 24202 13 M Gold Foil Posterior Class Ii Gold Foil Posterior Class Ii false true false 0 0 1468 0 false 24203 13 M Gold Foil Posterior Class V Gold Foil Posterior Class V false true false 0 0 1468 0 false 25111 13 M Inlays, Metal 1S Inlays, Metal 1S true true true 0 0 1448 1 MODBLIV 0 false 25112 13 M Inlays,Metal 2S Inlays,Metal 2S true true true 0 0 1448 2 MODBLIV 0 false 25113 13 M Inlays, Metal 3S Inlays, Metal 3S true true true 0 0 1448 3 MODBLIV 0 false 25114 13 M Inlays, Metal 4S Modified Inlays, Metal 4S Modified true true true 0 0 1919 4 MODBLIV 0 false 25121 13 M Inlays, Compsite Indirect 1S Inlays, Compsite Indirect 1S true true true 0 0 1448 1 MODBLIV 0 false 25122 13 M Inlays, Compsite Indirect 2S Inlays, Compsite Indirect 2S true true true 0 0 1448 2 MODBLIV 0 false 25123 13 M Inlays, Compsite Indirect 3S Inlays, Compsite Indirect 3S true true true 0 0 1448 3 MODBLIV 0 false 25124 13 M Inlays, Compsite Indirect 4S Inlays, Compsite Indirect 4S true true true 0 0 1919 4 MODBLIV 0 false 25131 13 B Inlays/Porcelain 1 Surf Inlays/Porcelain 1 Surf true true true 0 0 1919 1 MODBLIV false 25132 13 B Inlays/Porcelain 2 Surf Inlays/Porcelain 2 Surf true true true 0 0 1919 2 MODBLIV false 25133 13 B Inlays/Porcelain 3 Surf Inlays/Porcelain 3 Surf true true true 0 0 1919 3 MODBLIV false 25134 13 B Inlays/Porc/3 Surf. Modi. Inlays/Porc/3 Surf. Modi. true true true 0 0 1919 3 MODBLIV false 25141 13 M Inlays, Porcelain / Ceramic / Polymer Glass 1S Inlays, Porcelain / Ceramic / Polymer Glass 1S true true true 0 0 1448 1 MODBLIV 0 false 25142 13 M Inlays, Porcelain / Ceramic / Polymer Glass 2S Inlays, Porcelain / Ceramic / Polymer Glass 2S true true true 0 0 1448 2 MODBLIV 0 false 25143 13 M Inlays, Porcelain / Ceramic / Polymer Glass 3S Inlays, Porcelain / Ceramic / Polymer Glass 3S true true true 0 0 1448 3 MODBLIV 0 false 25144 13 M Inlays, Porcelain / Ceramic / Polymer Glass 3S Modified Inlays, Porcelain / Ceramic / Polymer Glass 3S Modified true true true 0 0 1919 4 MODBLIV 0 false 25511 13 M Onlays, Cast Metal, ndirect Onlays, Cast Metal, Indirect true true true 0 0 1919 1 MODBLIV 0 false 25512 13 B Onlays/Metal/Processed Onlays/Metal/Processed false false false 0 0 1919 0 MODBLIV false 25520 13 B Onlays, Composite/Compomer, Processed (bonded) Onlays, Composite/Compomer, Processed (bonded) true true true 0 0 1919 1 MODBLIV 0 false 0 25521 13 M Onlays, Composite Bonded Onlays, Composite Bonded true true true 0 0 1919 1 MODBLIV 0 false 25531 13 M Onlay, Porcelain / Ceramic / Polymer Glass Bonded Onlay, Porcelain / Ceramic / Polymer Glass Bonded true true true 0 0 1919 1 MODBLIV 0 false 25601 13 M 1 Pin Retentitive 1 Pin Retentitive true true false 0 0 1418 0 false 25602 13 M 2 Pin Retentive 2 Pin Retentive true true false 0 0 1418 0 false 25603 13 M 3 Pin Retentive 3 Pin Retentive true true false 0 0 1418 0 false 25604 13 M 4 Pin Retentive 4 Pin Retentive true true false 0 0 1418 0 false 25605 13 M 5 Pin Retentive 5 Pin Retentive true true false 0 0 1418 0 false 25711 13 M Posts (Core) Sep Proc 1 Sections Posts (Core) Sep Proc 1 Sections true true false 0 0 1418 0 false 25712 13 M Posts (Core) Sep Proc 2 Sections Posts (Core) Sep Proc 2 Sections true true false 0 0 1418 0 false 25713 13 M Posts (Core) Sep Proc 3 Sections Posts (Core) Sep Proc 3 Sections true true false 0 0 1418 0 false 25721 13 M Post ( Core ) Concurrent w/ Imp for Crown 1 Section Post ( Core ) Concurrent w/ Imp for Crown 1 Section true true false 0 0 1418 0 false 25722 13 M Post ( Core ) Concurrent w/ Imp for Crown 2 Section Post ( Core ) Concurrent w/ Imp for Crown 2 Section true true false 0 0 1418 0 false 25723 13 B Cast Metal Post & Core Cast Metal Post & Core false false false 0 0 1919 0 MODBLIV false 25724 13 B Post Cast As Part Of Crwn Post Cast As Part Of Crwn false false false 0 0 1919 MODBLIV false 25731 13 M 1Post, Prefabricated Retentitve 1Post, Prefabricated Retentitve false true false 0 0 1418 0 false 25732 13 M 2 Posts Same Tooth, Prefabricated Retentitive 2 Posts Same Tooth, Prefabricated Retentitive true true false 0 0 1418 0 false 25733 13 M 3 Posts Same Tooth, Prefabricated Retentitive 3 Posts Same Tooth, Prefabricated Retentitive true true false 0 0 1418 0 false 25741 13 B One Post/Cast Core One Post/Cast Core false false false 0 0 1919 0 MODBLIV false 25742 13 B Two Posts/Cast Core Two Posts/Cast Core false false false 0 0 1919 0 MODBLIV false 25743 13 B Three Posts/Cast Core Three Posts/Cast Core false false false 0 0 1919 0 MODBLIV false 25751 13 B Prefabr,Non-Bonded Core Prefabr,Non-Bonded Core false false false 0 0 1919 0 MODBLIV false 25752 13 B Prefabr,Non-Bonded Core Prefabr,Non-Bonded Core false false false 0 0 1919 0 MODBLIV false 25753 13 B Prefabr,Non-Bonded Core Prefabr,Non-Bonded Core false false false 0 0 1919 0 MODBLIV false 25754 22 M 1 Post, W/ Core Non - bonded & Pins 1 Post, W/ Core Non - bonded & Pins true true false 0 0 1418 0 false 25755 13 B Prefabr,Non-Bonded Core Prefabr,Non-Bonded Core false false false 0 0 1919 0 MODBLIV false 25756 13 B Prefabr,Non-Bonded Core Prefabr,Non-Bonded Core false false false 0 0 1919 0 MODBLIV false 25761 13 B Prefab, Bonded Core For Prefab, Bonded Core For false false false 0 0 1919 0 MODBLIV false 25762 13 B Bond Amal/Core 2posts Bond Amal/Core 2posts false false false 0 0 1919 0 MODBLIV false 25763 13 B Bond Amal/Core 3 Posts Bond Amal/Core 3 Posts false false false 0 0 1919 0 MODBLIV false 25764 13 B Bonded/Comp,Core 1 Post Bonded/Comp,Core 1 Post false false false 0 0 1919 0 MODBLIV false 25765 13 B B0nded/Comp,Core 2 Posts B0nded/Comp,Core 2 Posts false false false 0 0 1919 0 MODBLIV false 25766 13 B Bonded/Comp,Core 3 Posts Bonded/Comp,Core 3 Posts false false false 0 0 1919 0 MODBLIV false 25771 13 M Temporary Post Temporary Post true false false 0 0 false 25781 13 M Post Removal 1Unite Post Removal 1Unit true false false 0 0 false 25782 13 M Post Removal 2 Units Post Removal 2 Units true false false 0 0 false 25783 13 M Post Removal 3 Units Post Removal 3 Units true false false 0 0 false 25784 13 M Post Removal 4 Units Post Removal 4 Units true false false 0 0 false 25789 13 M Post Removal over 4 Post Removal ocer 4 true false false 0 0 false 26101 22 M Indirect, Angulat / Transmucosal Pre-fabricated Abut Indirect, Angulat / Transmucosal Pre-fabricated Abut true true false 0 0 1418 0 false 26102 22 M Indirect, Custom Lab Fbricated Indirect, Custom Lab Fbricated true true false 0 0 1418 0 false 26103 22 M Direct ( W/ intra-oral prep ) per Implant Site Direct ( W/ intra-oral prep ) per Implant Site true true false 0 0 1418 0 false 27111 13 M Crown Indirect Crown Indirect true true false 0 0 1418 0 false 27112 13 B Crown/Plastic/Proc/Compli Crown/Plastic/Proc/Compli false false false 0 0 1919 MODBLIV false 27113 13 M Crown - Tempory Indirect Crown - Tempory Indirect true true false 0 0 1418 0 false 27114 13 B Crowns/Plastic/Metal Base Crowns/Plastic/Metal Base false false false 0 0 1919 0 MODBLIV false 27115 13 B Crowns/Plas/Implant Screw Crowns/Plas/Implant Screw false false false 0 0 1919 0 MODBLIV false 27121 13 M Crown, Direct, Temporary Crown, Direct, Temporary true true false 0 0 1418 0 false 27122 13 B Crown/Plastic/Direct/Tran Crown/Plastic/Direct/Tran false false false 0 0 1919 MODBLIV false 27125 13 B Acrylic/Composite/Compome Acrylic/Composite/Compome false false false 0 0 1919 0 MODBLIV false 27131 13 M Crown, Cast Metal Base Indirect Crown, Cast Metal Base Indirect true true false 0 0 1418 0 false 27135 22 M Acrylic Crown, Implant supported Acrylic Crown, Implant supported true true false 0 0 1418 0 false 27136 13 B Crn/Acr/Comp/Comp/Cp/Ret Crn/Acr/Comp/Comp/Cp/Ret false false false 0 0 1919 0 MODBLIV false 27137 13 B Semi-Prec/Rest/Add Semi-Prec/Rest/Add false false false 0 0 1919 0 MODBLIV false 27138 13 B Semi-Prec/ Or Prec/Attach Semi-Prec/ Or Prec/Attach false false false 0 0 1919 0 MODBLIV false 27141 13 B Crn/Arc/Comp/Prov/Direct Crn/Arc/Comp/Prov/Direct false false false 0 0 1919 0 MODBLIV false 27145 13 B Crn/Arc/Comp/Prefab/Direc Crn/Arc/Comp/Prefab/Direc false false false 0 0 1919 0 MODBLIV false 27151 13 B Crn/Arc/Comp/Prov/Indirec Crn/Arc/Comp/Prov/Indirec false false false 0 0 1919 0 MODBLIV false 27155 13 B Acrylic/Compos/Compomer/ Acrylic/Compos/Compomer/ false false false 0 0 1919 0 MODBLIV false 27200 13 M Crown Prep (Impression) Crown Prep (Impression) false true false 0 0 1919 0 false 0 27201 13 M Porcelain Crown Porcelain Crown true true false 0 0 1418 0 false 27202 13 B Crown/Porc/Cer Jack/Compl Crown/Porc/Cer Jack/Compl false false false 0 0 1919 MODBLIV false 27205 22 M Porcelain Crown, Implant supported Porcelain Crown, Implant supported true true false 0 0 1418 0 false 27206 13 B Crown/Por/Cer/Post Reten Crown/Por/Cer/Post Reten false false false 0 0 1919 0 MODBLIV false 27211 13 M Porcelain / Metal Crown Porcelain / Metal Crown true true false 0 0 1418 0 false 27212 13 B Crown/Porcelain/Metal/Com Crown/Porcelain/Metal/Com false false false 0 0 1919 MODBLIV false 27213 13 M Porcelain / Metal Crown w/ Margin Porcelain / Metal Crown w/ Margin true true false 0 0 1919 0 false 27215 22 M Porcelain / Metal Crown, Implant supported Porcelain / Metal Crown, Implant supported true true false 0 0 1418 0 false 27216 13 B Crown/Por/Cer/Post Reten Crown/Por/Cer/Post Reten false false false 0 0 1919 0 MODBLIV false 27217 13 M Semi - precision Rest + Porcelain / metal Crown Semi - precision Rest + Porcelain / metal Crown true false false 0 0 1919 0 false 27218 13 M Semi - precision / RPD Retainer Semi - precision / RPD Retainer true false false 0 0 1919 0 false 27221 13 M Crown,3/4,Porcelain/Ceramic/Polymer Glass Crown, 3/4, Porcelain / Ceramic / Polymer Glass true false false 0 0 false 27222 13 B Crowns\porc\cer 3/4 P.V.C Crowns\porc\cer 3/4 P.V.C false false false 0 0 1919 MODBLIV false 27301 13 M Full Metal Crown Full Metal Crown true true false 0 0 1418 0 false 27302 13 B Crowns/Metal/Cast/Complic Crowns/Metal/Cast/Complic false false false 0 0 1919 MODBLIV false 27305 22 M Full Metal Crown, Implant supported Full Metal Crown, Implant supported true true false 0 0 1418 0 false 27306 13 B Crowns/Full/Metal/Post Re Crowns/Full/Metal/Post Re false false false 0 0 1919 0 MODBLIV false 27307 13 B Semi-Precision Rest Semi-Precision Rest false false false 0 0 1919 0 MODBLIV false 27308 13 B Semi-Prec/Prec/ Attach Semi-Prec/Prec/ Attach false false false 0 0 1919 0 MODBLIV false 27311 13 M 3/4 Metal Part Veneer Crown 3/4 Metal Part Veneer Crown true true false 0 0 1418 0 false 27312 13 B Crowns/Metal/3/4/Veneer C Crowns/Metal/3/4/Veneer C false false false 0 0 1919 MODBLIV false 27313 13 B Crowns/Metal/3/4/Ven/Dire Crowns/Metal/3/4/Ven/Dire false false false 0 0 1919 MODBLIV false 27317 13 B Semi-Prec/Rest Semi-Prec/Rest false false false 0 0 1919 0 MODBLIV false 27318 13 B Semi-Prec/Prec/ Attach Semi-Prec/Prec/ Attach false false false 0 0 1919 0 MODBLIV false 27401 13 M Crown Made to Fit Part of Denture Clasp (1 Crown) Crown Made to Fit Part of Denture Clasp (1 Crown) false true false 0 0 1418 0 false 27409 13 M Crown Made to Fit Part of Denture Clasp ( add Crown) Crown Made to Fit Part of Denture Clasp ( add Crown) false false false 0 0 false 27501 13 B Copings/Metal/Seperate Copings/Metal/Seperate false false false 0 0 1919 0 MODBLIV false 27502 13 B Copings/Metal/Concurrent Copings/Metal/Concurrent false false false 0 0 1919 0 MODBLIV false 27503 13 B Copings/Metal/Plas/Thimbl Copings/Metal/Plas/Thimbl false false false 0 0 1919 0 MODBLIV false 27504 13 B Copings/Metal/Plas Trans Copings/Metal/Plas Trans false false false 0 0 1919 0 MODBLIV false 27511 13 M Copings, Metal / Acrylic ( As Separate Procedure ) Copings, Metal / Acrylic ( As Separate Procedure ) true false false 0 0 false 27519 13 M Copings, Metal / Acrylic ( Add Procedure) Copings, Metal / Acrylic ( Add Procedure) true false false 0 0 false 27521 13 B Coping/Met/Acry/Impr/Crwn Coping/Met/Acry/Impr/Crwn false false false 0 0 1919 0 MODBLIV false 27601 13 M Veneers, Acrylic / Composite Bonded Veneers, Acrylic / Composite Bonded true true false 0 0 1418 0 false 27602 13 M Veneers, Porcelain Bonded Veneers, Porcelain Bonded true true false 0 0 1418 0 false 27711 13 M Repairs, Inlays, Onlays Crown Direct Repairs, Inlays, Onlays Crown Direct true true false 0 0 1418 0 false 27721 13 M Repairs, Inlays, Onlays Crown Porcelain / Ceramic / Polymer Glass ( Direct ) epairs, Inlays, Onlays Crown Porcelain / Ceramic / Polymer Glass ( Direct ) true true false 0 0 1418 0 false 27722 13 M Repairs, Inlays, Onlays, Crown Porcelain / Ceramic / Polymer Glass ( Indirect ) Repairs, Inlays, Onlays, Crown Porcelain / Ceramic / Polymer Glass ( Indirect ) true true false 0 0 1919 0 false 27801 13 M Recontouring Of Existing Crown 1 Unit Recontouring Of Existing Crown 1 Unit true true false 0 0 1418 0 false 27809 13 M Recontouring Of Existing Crown Add Unit Recontouring Of Existing Crown Add Unit true true false 0 0 1418 0 false 28101 13 M Overdentures, Direct Natural Tooth Restoration Overdentures, Direct Natural Tooth Restoration false true false 0 0 1418 0 false 28102 13 M Direct Natural Tooth Prep & Flouride Direct Natural Tooth Prep & Flouride false true false 0 0 1418 0 false 28103 13 M Direct Prefabrecated Attach to Natural Tooth Direct Prefabrecated Attach to Natural Tooth true true false 0 0 1418 0 false 28105 22 M Implant supported Attach as an Overdenture Implant supported Attach as an Overdenture true false false 0 0 false 28211 13 M Indirect, Coping Crown,Cast Metal, No Attach Indirect, Coping Crown,Cast Metal, No Attach true true false 0 0 1418 0 false 28212 13 B Coping/Crowns/Attachment Coping/Crowns/Attachment false false false 0 0 1919 0 MODBLIV false 28215 13 M Crown Coping, No Attach, Implant supported, Indirect Crown Coping, No Attach, Implant supported, Indirect true true false 0 0 1919 0 false 28216 13 B Coping Crown/Reten Post/N Coping Crown/Reten Post/N false false false 0 0 1919 0 MODBLIV false 28221 13 M Coping Crown W/ Attach, Indirect Coping Crown W/ Attach, Indirect true true false 0 0 1919 0 false 28225 13 M Coping Crown W/ Attach, Implant Coping Crown W/ Attach, Implant true true false 0 0 1919 0 false 28226 13 B Coping Cpown/Reten/Pst/At Coping Cpown/Reten/Pst/At false false false 0 0 1919 0 MODBLIV false 29100 13 B Crowns/Space Maintainers Crowns/Space Maintainers false false false 0 0 1919 MODBLIV false 29101 13 M Recementation Crowns 1 Unit Recementation Crowns 1 Unit true true false 0 0 1418 0 false 29102 13 M Recementation Crowns 2 Units Recementation Crowns 2 Units true true false 0 0 1418 0 false 29103 13 M Recementation Crowns 3 Units Recementation Crowns 3 Units true true false 0 0 1418 0 false 29104 13 M Recementation Crowns 4 Units Recementation Crowns 4 Units true true false 0 0 1418 0 false 29109 13 M Recementation Crowns Over 4 Units Recementation Crowns Over 4 Units true true false 0 0 1418 0 false 29111 22 M Recementation Implant Crown 1 Unit Recementation Implant Crown 1 Unit true false false 0 0 1418 0 false 29112 22 M Recementation Implant Crown 2 Units Recementation Implant Crown 2 Units true false false 0 0 1418 0 false 29113 22 M Recementation Implant Crown 3 Units Recementation Implant Crown 3 Units true false false 0 0 1418 0 false 29114 22 M Recementation Implant Crown 4 Units Recementation Implant Crown 4 Units true false false 0 0 1418 0 false 29119 13 B Reinsert/Implt-Supp Add Reinsert/Implt-Supp Add false false false 0 0 1919 0 MODBLIV false 29301 13 M Crown Removal 1 Unit Crown Removal 1 Unit true true false 0 0 1418 0 false 29302 13 M Crown Removal 2 Units Crown Removal 2 Units true true false 0 0 1418 0 false 29303 13 B Removal, Inlays/Onlays/Cr Removal, Inlays/Onlays/Cr false false false 0 0 1919 0 MODBLIV false 29304 13 B Removal, Inlays/Onlays/Cr Removal, Inlays/Onlays/Cr false false false 0 0 1919 0 MODBLIV false 29309 13 B Removal, Inlays/Onlays/Cr Removal, Inlays/Onlays/Cr false false false 0 0 1919 0 MODBLIV false 29311 22 M Removal, Implant Crown 1 Unit Removal, Implant Crown 1 Unit fa