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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 false false false 0 0 1418 0 false 29312 22 M Removal, Implant Crown 2 Units Removal, Implant Crown 2 Units false false false 0 0 1418 0 false 29313 22 M Removal, Implant Crown 3 Units Removal, Implant Crown 3 Units false false false 0 0 1418 0 false 29314 22 M Removal, Implant Crown 4 Units Removal, Implant Crown 4 Units false false false 0 0 1418 0 false 29319 13 B Remov/Impl/Sup/Crwn Add Remov/Impl/Sup/Crwn Add false false false 0 0 1919 0 MODBLIV false 29321 22 M Removal, Mesostructure 1 Unit Removal, Mesostructure 1 Unit false false false 0 0 1418 0 false 29322 22 M Removal, Mesostructur 2 Units Removal, Mesostructure 2 Units false false false 0 0 1418 0 false 29323 22 M Removal, Mesostructure 3Units Removal, Mesostructure 3Units false false false 0 0 1418 0 false 29324 22 M Removal, Mesostructure 4 Units Removal, Mesostructure 4Units false false false 0 0 1418 0 false 29329 13 B Removal Mesostruc/ Add Un Removal Mesostruc/ Add Un false false false 0 0 1919 0 MODBLIV false 29331 22 M Removal, Compromised Meso1 Unit Removal, Compromised Meso 1 Unit false false false 0 0 1418 0 false 29332 22 M Removal, Compromised Meso 2 Units Removal, Compromised Meso 2 Units false false false 0 0 1418 0 false 29333 22 M Removal, Compromised Meso 3 Units Removal, Compromised Meso 3 Units false false false 0 0 1418 0 false 29334 22 M Removal, Compromised Meso 4 Units Removal, Compromised Meso 4 Units false false false 0 0 1418 0 false 29339 13 B Removal Comp Mesost/Add Removal Comp Mesost/Add false false false 0 0 1919 0 MODBLIV false 29341 22 M Removal & Replace Abutment 1 Unit Removal & Replace Abutment 1 Unit true true false 0 0 1418 0 false 29342 22 M Removal & Replace Abutment 2 Units Removal & Replace Abutment 2 Units true true false 0 0 1418 0 false 29343 22 M Removal & Replace Abutment 3 Units Removal & Replace Abutment 3 Units true true false 0 0 1418 0 false 29344 22 M Removal & Replace Abutment 4 Units Removal & Replace Abutment 4 Units true true false 0 0 1418 0 false 29349 13 B Rem&replac/Heal,Abut,Add Rem&replac/Heal,Abut,Add false false false 0 0 1919 0 MODBLIV false 29351 13 B Implant-sup Crown Ret.Screw Removal, Fractured false false false 0 0 false 0 29352 13 B Implant-sup Crown Ret.Screw Removal, Fractured false false false 0 0 false 0 29353 13 B Implant-sup Crown Ret.Screw Removal, Fractured false false false 0 0 false 0 29354 13 B Implant-sup Crown Ret.Screw Removal, Fractured false false false 0 0 false 0 29359 13 B Implant-sup Crown Ret.Screw Removal, Fractured false false false 0 0 false 0 29401 13 B Staining/Porcelain/1 Unit Staining/Porcelain/1 Unit false false false 0 0 1919 MODBLIV false 29402 13 B Staining/Porcelain/2units Staining/Porcelain/2units false false false 0 0 1919 MODBLIV false 29403 13 B Staining/Porcelain/3units Staining/Porcelain/3units false false false 0 0 1919 MODBLIV false 29404 13 B Staining/Porcelain/4units Staining/Porcelain/4units false false false 0 0 1919 MODBLIV false 29409 13 B Staining/Porcelain/Addit Staining/Porcelain/Addit false false false 0 0 1919 MODBLIV false 29501 13 B Implant - supported Crown Impression Only false false false 0 0 false 0 29509 13 B Implant - supported Crown Impression Only false false false 0 0 false 0 29900 13 M Precision Attachments Precision Attachments true true false 0 0 1919 0 false 30010 14 B Exam Complete, Maxillary Exam Complete, Maxillary false false false 0 0 1919 0 MODBLIV false 30020 14 B Exam Complete, Mandibular Exam Complete, Mandibular false false false 0 0 1919 0 MODBLIV false 30030 14 B Exam Complete Max & Mand Exam Complete Max & Mand false false false 0 0 1919 0 MODBLIV false 30031 14 B Exam Complete Max&par/Man Exam Complete Max&par/Man false false false 0 0 1919 0 MODBLIV false 30101 14 B Exam/Dent/Followup, Post Exam/Dent/Followup, Post false false false 0 0 1919 0 MODBLIV false 30102 14 B Exam/Dent/Specific Nature Exam/Dent/Specific Nature false false false 0 0 1919 0 MODBLIV false 30103 14 B Exam/Dent/Preauthorizatio Exam/Dent/Preauthorizatio false false false 0 0 1919 0 MODBLIV false 30104 14 B Exam/Dentures/Emergency Exam/Dentures/Emergency false false false 0 0 1919 0 MODBLIV false 30105 14 B Exam/Dentures/Annual Exam/Dentures/Annual false false false 0 0 1919 0 MODBLIV false 30106 14 B Exam/Dent/Radiographics Exam/Dent/Radiographics false false false 0 0 1919 0 MODBLIV false 30201 14 B Exam/Dent/Diagnostic Cast Exam/Dent/Diagnostic Cast false false false 0 0 1919 0 MODBLIV false 31110 14 B Complete Max Prec- Equil Complete Max Prec- Equil false false false 0 0 1919 0 MODBLIV false 31120 14 B Complete Mand Prec - Equi Complete Mand Prec - Equi false false false 0 0 1919 0 MODBLIV false 31130 14 B Complete Max & Mand Prec Complete Max & Mand Prec false false false 0 0 1919 0 MODBLIV false 31310 14 B Complete Max Standard Complete Max Standard false false false 0 0 1919 0 MODBLIV false 31311 14 B Max Standard Max Standard false false false 0 0 1919 0 MODBLIV false 31312 14 B Comp Max Stand Soft Linin Comp Max Stand Soft Linin false false false 0 0 1919 0 MODBLIV false 31320 14 B Complete Mand Standard Complete Mand Standard false false false 0 0 1919 0 MODBLIV false 31321 14 B Mand Standard Mand Standard false false false 0 0 1919 0 MODBLIV false 31322 14 B Comp Mand Stand Soft Lin Comp Mand Stand Soft Lin false false false 0 0 1919 0 MODBLIV false 31330 14 B Comp. Max & Mand Standard Comp. Max & Mand Standard false false false 0 0 1919 0 MODBLIV false 31331 14 B Max & Mand Standard Max & Mand Standard false false false 0 0 1919 0 MODBLIV false 31332 14 B Comp Max & Mand Perm Soft Comp Max & Mand Perm Soft false false false 0 0 1919 0 MODBLIV false 31333 14 B Comp Max & Mand (mand) Comp Max & Mand (mand) false false false 0 0 1919 0 MODBLIV false 31510 14 B Max Transitional Max Transitional false false false 0 0 1919 0 MODBLIV false 31511 14 B Max Transitional Max Transitional false false false 0 0 1919 0 MODBLIV false 31520 14 B Mand Transitional Mand Transitional false false false 0 0 1919 0 MODBLIV false 31521 14 B Mand Transitional Mand Transitional false false false 0 0 1919 0 MODBLIV false 31530 14 B Mand & Max Transitional Mand & Max Transitional false false false 0 0 1919 0 MODBLIV false 31531 14 B Max & Mand Transitional Max & Mand Transitional false false false 0 0 1919 0 MODBLIV false 31610 14 B Max Overdenture Max Overdenture false false false 0 0 1919 0 MODBLIV false 31611 14 B Max Overdenture Max Overdenture false false false 0 0 1919 0 MODBLIV false 31620 14 B Mand Overdenture Mand Overdenture false false false 0 0 1919 0 MODBLIV false 31621 14 B Mand Overdenture Mand Overdenture false false false 0 0 1919 0 MODBLIV false 31630 14 B Max And Mand Overdenture Max And Mand Overdenture false false false 0 0 1919 0 MODBLIV false 31631 14 B Max And Mand Overdenture Max And Mand Overdenture false false false 0 0 1919 0 MODBLIV false 31710 14 B Max On Implants Max On Implants false false false 0 0 1919 0 MODBLIV false 31720 14 B Mand On Implants Mand On Implants false false false 0 0 1919 0 MODBLIV false 31730 14 B Max And Mand On Implants Max And Mand On Implants false false false 0 0 1919 0 MODBLIV false 31810 14 B Max On Implants Max On Implants false false false 0 0 1919 0 MODBLIV false 31820 14 B Mand On Implants Mand On Implants false false false 0 0 1919 0 MODBLIV false 31830 14 B Max & Mand On Implants Max & Mand On Implants false false false 0 0 1919 0 MODBLIV false 32110 14 B Comp. Max Lab Proc. Comp. Max Lab Proc. false false false 0 0 1919 0 MODBLIV false 32120 14 B Comp Mand Lab Proc. Comp Mand Lab Proc. false false false 0 0 1919 0 MODBLIV false 32130 14 B Comp Max & Mand Lab Proc Comp Max & Mand Lab Proc false false false 0 0 1919 0 MODBLIV false 32210 14 B Comp Max Lab Proc. Comp Max Lab Proc. false false false 0 0 1919 0 MODBLIV false 32220 14 B Comp Mand Lab Proc Comp Mand Lab Proc false false false 0 0 1919 0 MODBLIV false 32221 14 B Pulpotomy Permanent Anterior / Bicuspid Pulpotomy Permanent Anterior / Bicuspid false true false 0 0 1415 0 false 32222 14 B Pulpotomy Permanent Molar Pulpotomy Permanent Molar false true false 0 0 1468 0 false 32230 14 B Comp Max&mand Lab Proc Comp Max&mand Lab Proc false false false 0 0 1919 0 MODBLIV false 32231 14 B Pulpotomy Primary - separate procedure Pulpotomy Primary - separate procedure false true false 0 0 5815 0 false 32232 14 B Pulpotomy Primary concurrent with Restorations Pulpotomy Primary concurrent with Restorations false true false 0 0 5815 0 false 32310 14 B Comp Max Temp Acr Comp Max Temp Acr false false false 0 0 1919 0 MODBLIV false 32311 14 B Pulpectomy 1 Canal Pulpectomy 1 Canal false true false 0 0 1818 0 false 32312 14 B Pulpectomy 2 Canals Pulpectomy 2 Canals false true false 0 0 1818 0 false 32313 14 B Pulpectomy 3 Canals Pulpectomy 3Canals false true false 0 0 1818 0 false 32314 14 B Pulpectomy 4Canals and Up Pulpectomy 4Canals and Up false true false 0 0 1818 0 false 32315 14 B Pulpectomy Difficult ccess in add Pulpectomy Difficult ccess in add false false false 0 0 false 32318 14 B Comp Max Soft Lining Comp Max Soft Lining false false false 0 0 1919 0 MODBLIV false 32320 14 B Comp Mand Temp Acr Comp Mand Temp Acr false false false 0 0 1919 0 MODBLIV false 32321 14 B Pulpectomy Primary Anterior Pulpectomy Primary Anterior false true false 0 0 5815 0 false 32322 14 B Pulpectomy Primary Posterior Pulpectomy Primary Posterior false true false 0 0 5835 0 false 32328 14 B Comp Mand Soft Lining Comp Mand Soft Lining false false false 0 0 1919 0 MODBLIV false 32330 14 B Comp Max&mand Temp Acr Comp Max&mand Temp Acr false false false 0 0 1919 0 MODBLIV false 32338 14 B Comp Max&mand Soft Lining Comp Max&mand Soft Lining false false false 0 0 1919 0 MODBLIV false 32410 14 B Comp Max Light Cured Comp Max Light Cured false false false 0 0 1919 0 MODBLIV false 32418 14 B Comp Max Perm Acr Comp Max Perm Acr false false false 0 0 1919 0 MODBLIV false 32420 14 B Comp Mand Light Cured Comp Mand Light Cured false false false 0 0 1919 0 MODBLIV false 32428 14 B Comp Mand Perm Acr Comp Mand Perm Acr false false false 0 0 1919 0 MODBLIV false 32430 14 B Comp Max&mand Light Cured Comp Max&mand Light Cured false false false 0 0 1919 0 MODBLIV false 32438 14 B Comp Max & Mand Perm Acr Comp Max & Mand Perm Acr false false false 0 0 1919 0 MODBLIV false 32510 14 B Comp Max Lab Proc Comp Max Lab Proc false false false 0 0 1919 0 MODBLIV false 32520 14 B Comp Mand Lab Proc Comp Mand Lab Proc false false false 0 0 1919 0 MODBLIV false 32620 14 B Comp Mand On Imp Comp Mand On Imp false false false 0 0 1919 0 MODBLIV false 33101 14 B Canal/Perm/Fully 1 Canal Canal/Perm/Fully 1 Canal false false false 0 0 1919 0 MODBLIV false 33102 14 B Canal/Perm/Fully 2 Canal Canal/Perm/Fully 2 Canal false false false 0 0 1919 0 MODBLIV false 33103 14 B Canal/Perm/Fully 3 Canal Canal/Perm/Fully 3 Canal false false false 0 0 1919 0 MODBLIV false 33104 14 B Canal/Perm/Fully 4 Canal Canal/Perm/Fully 4 Canal false false false 0 0 1919 0 MODBLIV false 33110 14 B Comp Max Lab Proc. Comp Max Lab Proc. false false false 0 0 1919 0 MODBLIV false 33111 14 B Root Canal, 1 Canal 1 Root Canal false true false 0 0 1818 0 false 33112 14 B Root Canal, 1 Canal, Difficult access 1 Root Canal, Difficult access false true false 0 0 1418 0 false 33113 14 B Root Canal, 1 Canal, Exceptional anatomy 1 Root Canal, Exceptional anatomy false true false 0 0 1418 0 false 33114 14 B Root Canal, 1 Canal, Calcified Canal 1 Root Canal, Calcified Canal false true false 0 0 1418 0 false 33115 14 B Root Canal, 1 Canal, Retreatment 1 Root Canal, Retreatment false true false 0 0 1818 0 false 33116 14 B Root Canal, 1 Canal, Continuing treatment 1 Root Canal, Continuing treatment false true false 0 0 1418 0 false 33120 14 B Comp Mand Lab Proc. Comp Mand Lab Proc. false false false 0 0 1919 0 MODBLIV false 33121 14 B Root Canal, 2 Canals 2 Root Canals false true false 0 0 1818 0 false 33122 14 B Root Canal, 2 Canals, Difficult access 2 Root Canals, Difficult access false true false 0 0 1418 0 false 33123 14 B Root Canal, 2 Canals, Exceptional anatomy 2 Root Canals, Exceptional anatomy false true false 0 0 1418 0 false 33124 14 B Root Canal, 2 Canals, Calcified Canals Root Canal, 2 Canals, Calcified Canals false true false 0 0 1418 0 false 33125 14 B Root Canal, 2 Canals, Retreatment Root Canal, 2 Canals, Retreatment false true false 0 0 1418 0 false 33126 14 B Root Canal, 2 Canals, Continuing treatment Root Canal, 2 Canals, Continuing treatment false true false 0 0 1418 0 false 33130 14 B Comp Max&mand Lab Proc. Comp Max&mand Lab Proc. false false false 0 0 1919 0 MODBLIV false 33131 14 B Root Canal, 3 Canals Root Canal, 3 Canals false true false 0 0 1818 0 false 33132 14 B Root Canal, 3 Canals, Difficult access Root Canal, 3 Canals, Difficult access false true false 0 0 1418 0 false 33133 14 B Root Canal, 3 Canals, Exceptional anatomy Root Canal, 3 Canals, Exceptional anatomy false true false 0 0 1418 0 false 33134 14 B Root Canal, 3 Canals, Calcified Canals Root Canal, 3 Canals, Calcified Canals false true false 0 0 1418 0 false 33135 14 B Root Canal, 3 Canals, Retreatment Root Canal, 3 Canals, Retreatment false true false 0 0 1418 0 false 33136 14 B Root Canal, 3 Canals, Continuing treatment Root Canal, 3 Canals, Continuing treatment false true false 0 0 1418 0 false 33141 14 B Root Canal, 4 Canals & Up Root Canal, 4 Canals & Up false true false 0 0 1818 0 false 33142 14 B Root Canal, 4 Canals & Up, Difficult access Root Canal, 4 Canals & Up, Difficult access false true false 0 0 1418 0 false 33143 14 B Root Canal, 4 Canals & Up, Exceptional anatomy Root Canal, 4 Canals & Up, Exceptional anatomy false true false 0 0 1418 0 false 33144 14 B Root Canal, 4 Canals & Up, Calcified Canals Root Canal, 4 Canals & Up, Calcified Canals false true false 0 0 1418 0 false 33145 14 B Root Canal, 4 Canals & Up, Retreatment Root Canal, 4 Canals & Up, Retreatment false true false 0 0 1418 0 false 33146 14 B Root Canal, 4 Canals & Up, Continuing treatment Root Canal, 4 Canals & Up, Continuing treatment false true false 0 0 1418 0 false 33401 14 B Root Canal, Primary Teeth, 1 Canal Root Canal, Primary Teeth, 1 Canal false true false 0 0 5818 0 false 33402 14 B Root Canal, Primary Teeth, 2 Canals Root Canal, Primary Teeth, 2 Canals false true false 0 0 5845 0 false 33403 14 B Root Canal, Primary Teeth, 3 Canals Root Canal, Primary Teeth, 3 Canals false true false 0 0 5845 0 false 33601 14 B Hard Tissue Repair 1 Canal Hard Tissue Repair 1 Canal false true false 0 0 1818 0 false 33602 14 B Hard Tissue Repair 2 Canals Hard Tissue Repair 2 Canals false true false 0 0 1818 0 false 33603 14 B Hard Tissue Repair 3 Canals Hard Tissue Repair 3 Canals false true false 0 0 1818 0 false 33604 14 B Hard Tissue Repair 4 Canals & Up Hard Tissue Repair 4 Canals & Up false true false 0 0 1818 0 false 33605 14 B Hard Tissue Repair, Difficult access in Add Hard Tissue Repair, Difficult access in Add false true false 0 0 1418 0 false 33611 14 B Re-insertion of Dentogenic Media 1 Canal Re-insertion of Dentogenic Media 1 Canal false true false 0 0 1818 0 false 33612 14 B Re-insertion of Dentogenic Media 2 Canals Re-insertion of Dentogenic Media 2 Canals false true false 0 0 1818 0 false 33613 14 B Re-insertion of Dentogenic Media 3 Canals Re-insertion of Dentogenic Media 3 Canals false true false 0 0 1818 0 false 33614 14 B Re-insertion of Dentogenic Media 4 Canals & Up Re-insertion of Dentogenic Media 4 Canals & Up false true false 0 0 1818 0 false 33621 14 B Obturation of Apexified, 1 Canal Obturation of Apexified, 1 Canal false true false 0 0 1818 0 false 33622 14 B Obturation of Apexified, 2 Canals Obturation of Apexified, 2 Canals false true false 0 0 1818 0 false 33623 14 B Obturation of Apexified, 3 Canals Obturation of Apexified, 3 Canals false true true 0 0 1818 5 MODBL 0 false 33624 14 B Obturation of Apexified, 4 Canals & Up Obturation of Apexified, 4 Canals & Up false true false 0 0 1818 0 false 34110 14 B Comp Max Dup Lab Proc Comp Max Dup Lab Proc false false false 0 0 1919 0 MODBLIV false 34111 14 B Apicoectomy, Max Anterior 1 Root Apicoectomy, Max Anterior 1 Root false true false 0 0 1818 0 false 34112 14 B Apicoectomy, Max Anterior 2 Roots Apicoectomy, Max Anterior 2 Roots false true false 0 0 1818 0 false 34113 14 B Apicoectomy, Max Anterior 3 Roots & up Apicoectomy, Max Anterior 3 Roots & up false true false 0 0 1919 0 false 34114 14 B Apical/Uncomp Add Roots Apical/Uncomp Add Roots false false false 0 0 1919 0 MODBLIV false 34120 14 B Comp Mand Dup Lab Proc Comp Mand Dup Lab Proc false false false 0 0 1919 0 MODBLIV false 34121 14 B Apicoectomy, Max Biscuspid 1 Root Apicoectomy, Max Biscuspid 1 Root false false false 0 0 false 34122 14 B Apicoectomy, Max Biscuspid 2 Roots Apicoectomy, Max Biscuspid 2 Roots false false false 0 0 false 34123 14 B Apicoectomy, Max Biscuspid 2 Roots Apicoectomy, Max Biscuspid 2 Roots false false false 0 0 false 34124 14 B Apical/Comp Add Roots Apical/Comp Add Roots false false false 0 0 1919 0 MODBLIV false 34130 14 B Comp Max&mand Dup Lab Pro Comp Max&mand Dup Lab Pro false false false 0 0 1919 0 MODBLIV false 34131 14 B Apicoectomy, Max Molar 1 Root Apicoectomy, Max Molar 1 Root false true false 0 0 1818 0 false 34132 14 B Apicoectomy, Max Molar 2 Roots Apicoectomy, Max Molar 2 Roots false true false 0 0 1818 0 false 34133 14 B Apicoectomy, Max Molar 3 Roots Apicoectomy, Max Molar 3 Roots false true false 0 0 1818 0 false 34134 14 B Apicoectomy, Max Molar 4 Roots & Up Apicoectomy, Max Molar 4 Roots & Up false true false 0 0 1418 0 false 34141 14 B Apicoectomy, Mand Anterior 1 Root Apicoectomy, Mand Anterior 1 Root false false false 0 0 false 34142 14 B Apicoectomy, Mand Anterior 2 Roots & Up Apicoectomy, Mand Anterior 2 Roots & Up false false false 0 0 false 34143 14 B Apical/Endo/Comp 3 Roots Apical/Endo/Comp 3 Roots false false false 0 0 1919 0 MODBLIV false 34151 14 B Apicoectomy, Mand Biscuspid 1 Root Apicoectomy, Mand Biscuspid 1 Root false false false 0 0 false 34152 14 B Apicoectomy, Mand Biscuspid 2 Roots Apicoectomy, Mand Biscuspid 2 Roots false false false 0 0 false 34153 14 B Apicoectomy, Mand Biscuspid 3 Roots & Up Apicoectomy, Mand Biscuspid 3 Roots & Up false false false 0 0 false 34161 14 B Apicoectomy, Mand Molar 1 Root Apicoectomy, Mand Molar 1 Root false false false 0 0 false 34162 14 B Apicoectomy, Mand Molar 2 Roots Apicoectomy, Mand Molar 2 Roots false false false 0 0 false 34163 14 B Apicoectomy, Mand Molar 3 Roots Apicoectomy, Mand Molar 3 Roots false false false 0 0 false 34164 14 B Apicoectomy, Mand Molar 4 Roots & Up Apicoectomy, Mand Molar 4 Roots & Up false false false 0 0 false 34211 14 B Retrofilling, Max Anterior 1 Canal Retrofilling, Max Anterior 1 Canal false true false 0 0 1818 0 false 34212 14 B Retrofilling, Max Anterior 2 Canals & Up Retrofilling, Max Anterior 2 Canals & Up false true false 0 0 1818 0 false 34213 14 B Retrofilling, Max Anterior 3 Canals & Up Retrofilling, Max Anterior 3 Canals & Up false true false 0 0 1919 0 false 34214 14 B Retro/Uncomp Lateral Retro/Uncomp Lateral false false false 0 0 1919 0 MODBLIV false 34215 14 B Retro/Uncomp Lateral Retro/Uncomp Lateral false false false 0 0 1919 0 MODBLIV false 34221 14 B Retrofilling, Max Bicuspid 1 Canal Retrofilling, Max Bicuspid 1 Canal false false false 0 0 false 34222 14 B Retrofilling, Max Bicuspid 2 Canals Retrofilling, Max Bicuspid 2 Canals false false false 0 0 false 34223 14 B Retrofilling, Max Bicuspid 3 Canals Retrofilling, Max Bicuspid 3 Canals false false false 0 0 false 34224 14 B Retrofilling, Max Bicuspid 4 Canals and Up Retrofilling, Max Bicuspid 4 Canals and Up false true false 0 0 1418 0 false 34225 14 B Retro/Comp Lateral Aspect Retro/Comp Lateral Aspect false false false 0 0 1919 0 MODBLIV false 34231 14 B Retrofilling, Max Molar 1 Canal Retrofilling, Max Molar 1 Canal false false false 0 0 false 34232 14 B Retrofilling, Max Molar 2 Canals Retrofilling, Max Molar 2 Canals false false false 0 0 false 34233 14 B Retrofilling, Max Molar 3 Canals Retrofilling, Max Molar 3 Canals false false false 0 0 false 34234 14 B Retrofilling, Max Molar 4 Canals and Up Retrofilling, Max Molar 4Canals and Up false false false 0 0 false 34241 14 B Retrofilling, Mand Anterior 1 Canal Retrofilling, Mand Anterior 1 Canal false false false 0 0 false 34242 14 B Retrofilling, Mand Anterior 2Canals & Up Retrofilling, Mand Anterior Canals & Up false false false 0 0 false 34251 14 B Retrofilling, Mand Bicuspid 1 Canal Retrofilling, Mand Bicuspid 1 Canal false false false 0 0 false 34252 14 B Retrofilling, Mand Bicuspid 2 Canals Retrofilling, Mand Bicuspid 2 Canals false false false 0 0 false 34253 14 B Retrofilling, Mand Bicuspid 3 Canals Retrofilling, Mand Bicuspid 3 Canals false false false 0 0 false 34254 14 B Retrofilling, Mand Bicuspid 4 Canals Retrofilling, Mand Bicuspid 4 Canals false false false 0 0 false 34261 14 B Retrofilling, Mand Molar 1 Canal Retrofilling, Mand Molar 1 Canal false false false 0 0 false 34262 14 B Retrofilling, Mand Molar 2 Canals Retrofilling, Mand Molar 2 Canals false false false 0 0 false 34263 14 B Retrofilling, Mand Molar 3 Canals Retrofilling, Mand Molar 3 Canals false false false 0 0 false 34264 14 B Retrofilling, Mand Molar 4 Canals & Up Retrofilling, Mand Molar 4 Canals & Up false false false 0 0 false 34311 14 B Retreatment, Max Anterior 1 Root Retreatment, Max Anterior 1 Root false false false 0 0 false 34312 14 B Retreatment, Max Anterior 2 Roots Retreatment, Max Anterior 2 Roots false false false 0 0 false 34321 14 B Retreatment, Max Bicuspid 1 Root Retreatment, Max Bicuspid 1 Root false false false 0 0 false 34322 14 B Retreatment, Max Bicuspid 2 Roots Retreatment, Max Bicuspid 2 Roots false false false 0 0 false 34323 14 B Retreatment, Max Bicuspid 3 Roots Retreatment, Max Bicuspid 3 Roots false false false 0 0 false 34324 14 B Retreatment, Max Bicuspid 4 Roots & Up Retreatment, Max Bicuspid 4 Roots & Up false false false 0 0 false 34331 14 B Retreatment, Max Molar 1 Root Retreatment, Max Molar 1 Root false false false 0 0 false 34332 14 B Retreatment, Max Molar2 Roots Retreatment, Max Molar 2 Roots false false false 0 0 false 34333 14 B Retreatment, Max Molar 3 Roots Retreatment, Max Molar 3 Roots false false false 0 0 false 34334 14 B Retreatment, Max Molar 4 Roots & Up Retreatment, Max Molar 4 Roots & Up false false false 0 0 false 34341 14 B Retreatment, Mand Anterior 1 Root Retreatment, Mand Anterior 1 Root false false false 0 0 false 34342 14 B Retreatment, Mand Anterior 2 Roots Retreatment, Mand Anterior 2 Roots false false false 0 0 false 34351 14 B Retreatment, Mand Bicuspid 1 Root Retreatment, Mand Bicuspid 1 Root false false false 0 0 false 34352 14 B Retreatment, Mand Bicuspid 2 Roots Retreatment, Mand Bicuspid 2 Roots false false false 0 0 false 34353 14 B Retreatment, Mand Bicuspid 3 Roots Retreatment, Mand Bicuspid 3 Roots false false false 0 0 false 34354 14 B Retreatment, Mand Bicuspid 4 Roots & Up Retreatment, Mand Bicuspid 4 Roots & Up false false false 0 0 false 34361 14 B Retreatment, Mandibular Molar 1 Root Retreatment, Mandibular Molar 1 Root false false false 0 0 false 34362 14 B Retreatment, Mandibular Molar 2 Roots Retreatment, Mandibular Molar 2 Roots false false false 0 0 false 34363 14 B Retreatment, Mandibular Molar 3 Roots Retreatment, Mandibular Molar 3 Roots false false false 0 0 false 34364 14 B Retreatment, Mandibular Molar 4 Roots & Up Retreatment, Mandibular Molar 4 Roots & Up false false false 0 0 false 34400 14 B Crowns/Rest/Stainless Pri Crowns/Rest/Stainless Pri false false false 0 0 1919 MODBLIV false 34411 14 B Amputations,1 Root Amputations, 1 Root false true false 0 0 1818 0 false 34412 14 B Amputations, 2 Roots Amputations 2 Roots false true false 0 0 1818 0 false 34421 14 B Hemisection, Max Bicuspid Hemisection, Max Bicuspid false true false 0 0 1919 0 false 34422 14 B Hemisection, Max Molar Hemisection, Max Molar false true false 0 0 1268 0 false 34423 14 B Hemisection, Mand Molar Hemisection, Mand Molar false true false 0 0 3468 0 false 34431 14 B Decompression, 1st Visit Decompression, 1st Visit false false false 0 0 false 34432 14 B Decompression, Each Add Visit Decompression, Each Add Visit false false false 0 0 false 34441 14 B Surg, Endo, Explor, Max Anterior Surg, Endo, Explor, Max Anterior false true false 0 0 1418 0 false 34442 14 B Surg, Endo, Explor, Max Bicuspid Surg, Endo, Explor, Max Bicuspid false true false 0 0 1418 0 false 34443 14 B Surg, Endo, Explor, Max Molar Surg, Endo, Explor, Max Molar false false false 0 0 false 34444 14 B Surg, Endo, Explor, Mand Anterior Surg, Endo, Explor, Mand Anterior false false false 0 0 false 34445 14 B Surg, Endo, Explor, Mand Bicuspid Surg, Endo, Explor, Mand Bicuspid false true false 0 0 1418 0 false 34446 14 B Surg, Endo, Explor, Mand Molar Surg, Endo, Explor, Mand Molar false false false 0 0 false 34451 14 B Removal, Single Rooted Tooth Removal, Single Rooted Tooth false true false 0 0 1418 0 false 34452 14 B Removal, 2 Rooted Tooth Removal, 2 Rooted Tooth true true false 0 0 1418 0 false 34453 14 B Removal, 3 Rooted Tooth & Up Removal, 3 Rooted Tooth & Up false false false 0 0 false 34461 14 B Implant/Endo/Intra 1 Root Implant/Endo/Intra 1 Root false false false 0 0 1919 0 MODBLIV false 34462 14 B Implant/Endo/Intra 2 Root Implant/Endo/Intra 2 Root false false false 0 0 1919 0 MODBLIV false 34471 14 B Implant/Endo/Intra/Obliqu Implant/Endo/Intra/Obliqu false false false 0 0 1919 0 MODBLIV false 34500 14 B Crowns/Rest/Stainless Per Crowns/Rest/Stainless Per false false false 0 0 1919 MODBLIV false 34511 14 B Perforation, Root Repair, per tooth Perforation, Root Repair, per tooth false true false 0 0 1813 0 false 34521 14 B Perforation, Root Repair ( Sugical ) Anterior tooth Perforation, Root Repair ( Sugical ) Anterior tooth false true false 0 0 1868 0 false 34522 14 B Perforation, Root Repair ( Sugical ) Bicuspidr tooth Perforation, Root Repair ( Sugical ) Bicuspidr tooth false true false 0 0 1868 0 false 34523 14 B Perforation, Root Repair ( Sugical ) Molar tooth Perforation, Root Repair ( Sugical ) Molar tooth false false false 0 0 false 34600 14 B Crowns/Rest/Stainless O-F Crowns/Rest/Stainless O-F false false false 0 0 1919 MODBLIV false 34601 14 B nlargement, Canal and or Pulp Chamber - Peviously Filled Enlargement, Canal or Pulp Chamber - Peviously Filled false true false 0 0 1418 0 false 34602 14 B Enlargement , Canal or Pulp Chamber - Calcified Canals Enlargement , Canal or Pulp Chamber - Calcified Canals false true false 0 0 1418 0 false 34603 14 B Enlarge Canal/Chamber 3un Enlarge Canal/Chamber 3un false false false 0 0 1919 0 MODBLIV false 34609 14 B Enlarge Canal/Chamber Add Enlarge Canal/Chamber Add false false false 0 0 1919 0 MODBLIV false 34700 14 B Crowns/Rest/Temporary Crowns/Rest/Temporary false false false 0 0 1919 MODBLIV false 34701 14 B Comp Max, Part. Mand Comp Max, Part. Mand false false false 0 0 1919 0 MODBLIV false 34711 14 B Altered Cast Imp Altered Cast Imp false false false 0 0 1919 0 MODBLIV false 34800 14 B Crowns/Rest/Cast Mtl Sep Crowns/Rest/Cast Mtl Sep false false false 0 0 1919 MODBLIV false 34900 14 B Crowns/Rest/Cast Mtl Impr Crowns/Rest/Cast Mtl Impr false false false 0 0 1919 MODBLIV false 35100 14 B Rest/Recement Crown Rest/Recement Crown false false false 0 0 1919 MODBLIV false 35110 14 B Comp Max Remount & Eqilib Comp Max Remount & Eqilib false false false 0 0 1919 0 MODBLIV false 35120 14 B Comp Mand Remount& Equil Comp Mand Remount& Equil false false false 0 0 1919 0 MODBLIV false 35130 14 B Comp Max&mand Remount &eq Comp Max&mand Remount &eq false false false 0 0 1919 0 MODBLIV false 35200 14 B Rest/Pin-Reinforced Amalg Rest/Pin-Reinforced Amalg false false false 0 0 1919 MODBLIV false 35210 14 B Comp Max Reset Comp Max Reset false false false 0 0 1919 0 MODBLIV false 35220 14 B Comp Mand Reset Comp Mand Reset false false false 0 0 1919 0 MODBLIV false 35230 14 B Comp Max&mand Reset Comp Max&mand Reset false false false 0 0 1919 0 MODBLIV false 35300 14 B Rest/Pin-Reinforced Comp Rest/Pin-Reinforced Comp false false false 0 0 1919 MODBLIV false 35400 14 B Rest/Sedative Filling Rest/Sedative Filling false false false 0 0 1919 MODBLIV false 35500 14 B Rest/Stainless Steel Band Rest/Stainless Steel Band false false false 0 0 1919 MODBLIV false 36100 14 B Amal/Rest/Perm/1 Surf Mol Amal/Rest/Perm/1 Surf Mol false false false 0 0 1919 MODBLIV false 36110 14 B Repair Comp Max No Imp Repair Comp Max No Imp false false false 0 0 1919 0 MODBLIV false 36120 14 B Repair Comp Mand No Imp Repair Comp Mand No Imp false false false 0 0 1919 0 MODBLIV false 36200 14 B Amal/Rest/Perm/2 Surf Mol Amal/Rest/Perm/2 Surf Mol false false false 0 0 1919 MODBLIV false 36210 14 B Repair Comp Max With Imp Repair Comp Max With Imp false false false 0 0 1919 0 MODBLIV false 36220 14 B Repair Comp Mand With Imp Repair Comp Mand With Imp false false false 0 0 1919 0 MODBLIV false 36300 14 B Amal/Rest/Perm/3 Surf Mol Amal/Rest/Perm/3 Surf Mol false false false 0 0 1919 MODBLIV false 36400 14 B Amal/Rest/Perm/4 Surf Mol Amal/Rest/Perm/4 Surf Mol false false false 0 0 1919 MODBLIV false 36500 14 B Amal/Rest/Perm/5 Surf Mol Amal/Rest/Perm/5 Surf Mol false false false 0 0 1919 MODBLIV false 36600 14 B Acry/Comp/Prim/ 1 Surf Acry/Comp/Prim/ 1 Surf false false false 0 0 1919 MODBLIV false 36700 14 B Acry/Comp/Prim/ 2 Surf Acry/Comp/Prim/ 2 Surf false false false 0 0 1919 MODBLIV false 36800 14 B Acry/Comp/Prim/ 3 Surf Acry/Comp/Prim/ 3 Surf false false false 0 0 1919 MODBLIV false 36900 14 B Acry/Comp/Prim/ 4 Surf Acry/Comp/Prim/ 4 Surf false false false 0 0 1919 MODBLIV false 37000 14 B Acry/Comp/Prim/ 5 Surf Acry/Comp/Prim/ 5 Surf false false false 0 0 1919 MODBLIV false 37100 14 B Acry/Comp/Perm1 Surf Bic Acry/Comp/Perm1 Surf Bic false false false 0 0 1919 MODBLIV false 37110 14 B Tissue Cond Comp Max Tissue Cond Comp Max false false false 0 0 1919 0 MODBLIV false 37120 14 B Tissue Cond Comp Mand Tissue Cond Comp Mand false false false 0 0 1919 0 MODBLIV false 37200 14 B Acry/Comp/Perm1 Surf Mol Acry/Comp/Perm1 Surf Mol false false false 0 0 1919 MODBLIV false 37300 14 B Acry/Comp/Perm2 Surf Bic Acry/Comp/Perm2 Surf Bic false false false 0 0 1919 MODBLIV false 37400 14 B Acry/Comp/Perm2 Surf Mol Acry/Comp/Perm2 Surf Mol false false false 0 0 1919 MODBLIV false 37500 14 B Acry/Comp/Perm3 Surf Bic Acry/Comp/Perm3 Surf Bic false false false 0 0 1919 MODBLIV false 37600 14 B Acry/Comp/Perm3 Surf Mol Acry/Comp/Perm3 Surf Mol false false false 0 0 1919 MODBLIV false 37700 14 B Acry/Comp/Perm4 Surf Bic Acry/Comp/Perm4 Surf Bic false false false 0 0 1919 MODBLIV false 37800 14 B Acry/Comp/Perm4 Surf Mol Acry/Comp/Perm4 Surf Mol false false false 0 0 1919 MODBLIV false 37900 14 B Acry/Comp/Perm5 Surf Bic Acry/Comp/Perm5 Surf Bic false false false 0 0 1919 MODBLIV false 38000 14 B Acry/Comp/Perm5 Surf Mol Acry/Comp/Perm5 Surf Mol false false false 0 0 1919 MODBLIV false 38110 14 B Adj Comp Max Adj Comp Max false false false 0 0 1919 0 MODBLIV false 38111 14 B Adj(lllt) Comp Max Adj(lllt) Comp Max false false false 0 0 1919 0 MODBLIV false 38120 14 B Adj Comp Mand Adj Comp Mand false false false 0 0 1919 0 MODBLIV false 38121 14 B Adj (lllt) Comp Mand Adj (lllt) Comp Mand false false false 0 0 1919 0 MODBLIV false 39101 14 B Isolation of Endo Tooth Isolation of Endo Tooth false true false 0 0 1418 0 false 39201 14 B Open and Drain, Anteriors and Bicuspids Open and Drain, Anteriors and Bicuspids false true false 0 0 1415 0 false 39202 14 B Open And Drain, Molars Open And Drain, Molars false true false 0 0 1468 0 false 39211 14 B Open and Drain Thru Artificial Crown, Anteriors & Bicuspids Open and Drain Thru Artificial Crown, Anteriors & Bicuspids false true false 0 0 1415 0 false 39212 14 B Open and Drain Thru Artificial Crown, Molars Open and Drain Thru Artificial Crown, Molars false true false 0 0 1468 0 false 39311 14 B Bleaching 1 Unit Bleaching 1 Unit false true false 0 0 1418 0 false 39312 14 B Bleaching 2 Units Bleaching 2 Units false true false 0 0 1418 0 false 39313 14 B Bleaching 3 Units Bleaching 3 Units false true false 0 0 1418 0 false 39319 14 B Bleaching 3 Units & Up Bleaching 3 Units & Up false true false 0 0 1418 0 false 39411 14 B Bleaching Exploratory Access, Anterior Bleaching Exploratory Access, Anterior false false false 0 0 false 39412 14 B Bleaching Exploratory Access, Bicuspid Bleaching Exploratory Access, Bicuspid false false false 0 0 false 39413 14 B Bleaching Exploratory Access, Molar Bleaching Exploratory Access, Molar false false false 0 0 false 39501 14 B Post Removal/Retreat 1 Un Post Removal/Retreat 1 Un false false false 0 0 1919 0 MODBLIV false 39502 14 B Post Removal/Retreat 2 Un Post Removal/Retreat 2 Un false false false 0 0 1919 0 MODBLIV false 39503 14 B Post Removal/Retreat 3 Un Post Removal/Retreat 3 Un false false false 0 0 1919 0 MODBLIV false 39504 14 B Post Removal/Retreat 4 Un Post Removal/Retreat 4 Un false false false 0 0 1919 0 MODBLIV false 39509 14 B Post Removal/Retreat Add Post Removal/Retreat Add false false false 0 0 1919 0 MODBLIV false 39614 14 B Remove/Post 4 Unit Remove/Post 4 Unit false false false 0 0 1919 0 MODBLIV false 39905 14 B Pulpectomy ( deciduous teeth ) Final Restoration Pulpectomy ( deciduous teeth ) Final Restoration false true false 0 0 1919 0 false 40010 15 B Exam Partial Maxillary Exam Partial Maxillary false false false 0 0 1919 0 MODBLIV false 40020 15 B Exam Partial Mandibular Exam Partial Mandibular false false false 0 0 1919 0 MODBLIV false 40030 15 B Exam Parital Max & Mand Exam Parital Max & Mand false false false 0 0 1919 0 MODBLIV false 40031 15 B Exam Partial Max&comp Man Exam Partial Max&comp Man false false false 0 0 1919 0 MODBLIV false 40101 15 B Exam,Part,Dent/Followup Exam,Part,Dent/Followup false false false 0 0 1919 0 MODBLIV false 40102 15 B Exam Specific Nature Exam Specific Nature false false false 0 0 1919 0 MODBLIV false 40103 15 B Exam For Preauthorization Exam For Preauthorization false false false 0 0 1919 0 MODBLIV false 40104 15 B Exam For Emergency Exam For Emergency false false false 0 0 1919 0 MODBLIV false 40105 15 B Exam - Annual Exam - Annual false false false 0 0 1919 0 MODBLIV false 40106 15 B Exam-Radiographs Exam-Radiographs false false false 0 0 1919 0 MODBLIV false 40201 15 B Diagnostic Casts Diagnostic Casts false false false 0 0 1919 0 MODBLIV false 41101 15 B Displace/Dress 1 Unit Displace/Dress 1 Unit false false false 0 0 1919 0 MODBLIV false 41102 15 B Displace/Dress 2 Unit Displace/Dress 2 Unit false false false 0 0 1919 0 MODBLIV false 41103 15 B Displace/Dress 3 Unit Displace/Dress 3 Unit false false false 0 0 1919 0 MODBLIV false 41104 15 B Displace/Dress 4 Unit Displace/Dress 4 Unit false false false 0 0 1919 0 MODBLIV false 41109 15 B Displace/Dress Add. Displace/Dress Add. false false false 0 0 1919 0 MODBLIV false 41114 15 B Free End Part Max Free End Part Max false false false 0 0 1919 0 MODBLIV false 41115 15 B Part Max Free End Part Max Free End false false false 0 0 1919 0 MODBLIV false 41124 15 B Free End Part Mand Free End Part Mand false false false 0 0 1919 0 MODBLIV false 41125 15 B Part Mand Free End Part Mand Free End false false false 0 0 1919 0 MODBLIV false 41134 15 B Part Max & Mand Free End Part Max & Mand Free End false false false 0 0 1919 0 MODBLIV false 41144 15 B Alt Cast Imp Free End Alt Cast Imp Free End false false false 0 0 1919 0 MODBLIV false 41211 15 B Oral Manifest, Oral Mucosal Disorders 1 Unit Oral Manifest, Oral Mucosal Disorders 1 Unit false false false 0 0 false 41212 15 B Oral Manifest, Oral Mucosal Disorders 2 Units Oral Manifest, Oral Mucosal Disorders 2 Units false false false 0 0 false 41213 15 B Oral Manifest, Oral Mucosal Disorders 3 Units Oral Manifest, Oral Mucosal Disorders 3 Units false false false 0 0 false 41214 15 B Oral Manifest, Oral Mucosal Disorders 4 Units Oral Manifest, Oral Mucosal Disorders 4 Units false false false 0 0 false 41215 15 B Part Max Tooth Borne Part Max Tooth Borne false false false 0 0 1919 0 MODBLIV false 41219 15 B Oral Manifest, Oral Mucosal Disorders over 4 Units Oral Manifest, Oral Mucosal Disorders over 4 Units false false false 0 0 false 41221 15 B Nervous and Muscular Disorders, 1 Unit Nervous and Muscular Disorders, 1 Unit false true false 0 0 1919 0 false 41222 15 B Nervous and Muscular Disorders, 2 Units Nervous and Muscular Disorders, 2 Units false true false 0 0 1919 0 false 41223 15 B Nervous and Muscular Disorders, 3 Units Nervous and Muscular Disorders, 3 Units false true false 0 0 1919 0 false 41224 15 B Nervous and Muscular Disorders, 4 Units Nervous and Muscular Disorders, 4 Units false false false 0 0 false 41225 15 B Part Mand Tooth Borne Part Mand Tooth Borne false false false 0 0 1919 0 MODBLIV false 41229 15 B Nervous and Muscular Disorders, over 4 Units Nervous and Muscular Disorders, over 4 Units false false false 0 0 false 41231 15 B Oral Manifestations of Systemic Disease, 1 Unit Oral Manifestations of Systemic Disease, 1 Unit false false false 0 0 false 41232 15 B Oral Manifestations of Systemic Disease, 2 Units Oral Manifestations of Systemic Disease, 2 Units false false false 0 0 false 41233 15 B Oral Manifestations of Systemic Disease, 3 Units Oral Manifestations of Systemic Disease, 3 Units false false false 0 0 false 41234 15 B Oral Manifestations of Systemic Disease, 4 Units Oral Manifestations of Systemic Disease, 4 Units false false false 0 0 false 41239 15 B Oral Manifestations of Systemic Disease over 4 Units Oral Manifestations of Systemic Disease, over 4 Units false false false 0 0 false 41254 15 B Part Max Tooth Borne Part Max Tooth Borne false false false 0 0 1919 0 MODBLIV false 41264 15 B Part Mand Tooth Borne Part Mand Tooth Borne false false false 0 0 1919 0 MODBLIV false 41274 15 B Part Max & Mand Tooth Bor Part Max & Mand Tooth Bor false false false 0 0 1919 0 MODBLIV false 41301 15 B Desensitization, 1 Unit Desensitization, 1 Unit false true false 0 1 1400 0 false 41302 15 B Desensitization, 2 Units Desensitization, 2 Units false true false 0 1 1400 0 false 41309 15 B Desensitization, 2Units & Up Desensitization, 2Units & Up false true false 0 1 1400 0 false 41510 15 B Part Max Overdenture Part Max Overdenture false false false 0 0 1919 0 MODBLIV false 41511 15 B Part Max Overdenture Part Max Overdenture false false false 0 0 1919 0 MODBLIV false 41520 15 B Part Mand Overdenture Part Mand Overdenture false false false 0 0 1919 0 MODBLIV false 41521 15 B Part Mand Overdenture Part Mand Overdenture false false false 0 0 1919 0 MODBLIV false 41530 15 B Part Max & Mand Overdent Part Max & Mand Overdent false false false 0 0 1919 0 MODBLIV false 41540 15 B Alt Cast Imp Overdenture Alt Cast Imp Overdenture false false false 0 0 1919 0 MODBLIV false 41601 15 B Part Max On Implants Part Max On Implants false false false 0 0 1919 0 MODBLIV false 41602 15 B Part Mand On Implants Part Mand On Implants false false false 0 0 1919 0 MODBLIV false 41603 15 B Max & Mand On Implants Max & Mand On Implants false false false 0 0 1919 0 MODBLIV false 41604 15 B Alt Cast Imp On Implants Alt Cast Imp On Implants false false false 0 0 1919 0 MODBLIV false 41610 15 B Part Max Standard - Clasp Part Max Standard - Clasp false false false 0 0 1919 0 MODBLIV false 41611 15 B Part Max Standard Clasps Part Max Standard Clasps false false false 0 0 1919 0 MODBLIV false 41612 15 B Part Max Std - No Clasp Part Max Std - No Clasp false false false 0 0 1919 0 MODBLIV false 41613 15 B Part Max Std No Clasp Part Max Std No Clasp false false false 0 0 1919 0 MODBLIV false 41620 15 B Part Mand Standard -Clasp Part Mand Standard -Clasp false false false 0 0 1919 0 MODBLIV false 41621 15 B Part Mand Std Clasps Part Mand Std Clasps false false false 0 0 1919 0 MODBLIV false 41622 15 B Part Mand Std-No Clasp Part Mand Std-No Clasp false false false 0 0 1919 0 MODBLIV false 41623 15 B Part Mand Std No Clasp Part Mand Std No Clasp false false false 0 0 1919 0 MODBLIV false 41630 15 B Part Max&mand Standard-Cl Part Max&mand Standard-Cl false false false 0 0 1919 0 MODBLIV false 41632 15 B Part Max&mand Std-No Clas Part Max&mand Std-No Clas false false false 0 0 1919 0 MODBLIV false 41710 15 B Part Max Trans. Clasp Part Max Trans. Clasp false false false 0 0 1919 0 MODBLIV false 41711 15 B Part Max Trans Clasp Part Max Trans Clasp false false false 0 0 1919 0 MODBLIV false 41712 15 B Part Max Trans - No Clasp Part Max Trans - No Clasp false false false 0 0 1919 0 MODBLIV false 41713 15 B Part Max Trans No Clasp Part Max Trans No Clasp false false false 0 0 1919 0 MODBLIV false 41720 15 B Part Mand Trans - Clasp Part Mand Trans - Clasp false false false 0 0 1919 0 MODBLIV false 41721 15 B Part Mand Trans Clasps Part Mand Trans Clasps false false false 0 0 1919 0 MODBLIV false 41722 15 B Part Mand Trans - No Clas Part Mand Trans - No Clas false false false 0 0 1919 0 MODBLIV false 41723 15 B Part Mand Trans No Clasp Part Mand Trans No Clasp false false false 0 0 1919 0 MODBLIV false 41730 15 B Part Max & Mand Trans-Cla Part Max & Mand Trans-Cla false false false 0 0 1919 0 MODBLIV false 41732 15 B Part Max&mand Trans No C Part Max&mand Trans No C false false false 0 0 1919 0 MODBLIV false 41810 15 B Part Max Overdenture Part Max Overdenture false false false 0 0 1919 0 MODBLIV false 41811 15 B Part Max Overdenture Clas Part Max Overdenture Clas false false false 0 0 1919 0 MODBLIV false 41812 15 B Part Max Overdenture No C Part Max Overdenture No C false false false 0 0 1919 0 MODBLIV false 41813 15 B Part Mand Overdenture Cla Part Mand Overdenture Cla false false false 0 0 1919 0 MODBLIV false 41814 15 B Part Max Overdenture No C Part Max Overdenture No C false false false 0 0 1919 0 MODBLIV false 41820 15 B Part Mand Overdenture Part Mand Overdenture false false false 0 0 1919 0 MODBLIV false 41822 15 B Part Mand Overdenture No Part Mand Overdenture No false false false 0 0 1919 0 MODBLIV false 41823 15 B Part Mand Overdenture No Part Mand Overdenture No false false false 0 0 1919 0 MODBLIV false 41830 15 B Part Max&mand Overdenture Part Max&mand Overdenture false false false 0 0 1919 0 MODBLIV false 41832 15 B Part Max&mand Overdenture Part Max&mand Overdenture false false false 0 0 1919 0 MODBLIV false 42100 15 B Incis&drainage/Absc/Intra Incis&drainage/Absc/Intra false false false 0 0 1919 MODBLIV false 42110 15 B Part Max Lab Proc. Part Max Lab Proc. false false false 0 0 1919 0 MODBLIV false 42111 15 B Gingival Curretage Per Site Gingival Curretage Per Site false true false 0 2 0038 0 false 42120 15 B Part Mand Lab Proc. Part Mand Lab Proc. false false false 0 0 1919 0 MODBLIV false 42121 15 B Surgical Curettage, Debridement, affected by inflammation or infection Surgical Curettage, Debridement, affected by inflammation or infection false false false 0 0 false 0 42128 15 B Part Mand Perm Acr Part Mand Perm Acr false false false 0 0 1919 0 MODBLIV false 42130 15 B Part Max&mand Lab Proc. Part Max&mand Lab Proc. false false false 0 0 1919 0 MODBLIV false 42200 15 B Incis&drainage/Absc/Extra Incis&drainage/Absc/Extra false false false 0 0 1919 MODBLIV false 42201 15 B Gingivoplasty Per Site Gingivoplasty Per Site false true false 0 2 0038 0 false 42210 15 B Part Max Lab Proc Part Max Lab Proc false false false 0 0 1919 0 MODBLIV false 42211 15 B Periodontal Surgery, Gingivoplasty - Around an Impact Periodontal Surgery, Gingivoplasty - Around an Impact false false false 0 0 false 0 42220 15 B Part Mand Lab Proc Part Mand Lab Proc false false false 0 0 1919 0 MODBLIV false 42230 15 B Part Max&mand Lab Proc Part Max&mand Lab Proc false false false 0 0 1919 0 MODBLIV false 42310 15 B Part Max Temp Acr Part Max Temp Acr false false false 0 0 1919 0 MODBLIV false 42311 15 B Gingivectomy Per Site Gingivectomy Per Site false true false 0 2 0038 0 false 42318 15 B Part Max Soft Lining Part Max Soft Lining false false false 0 0 1919 0 MODBLIV false 42320 15 B Part Mand Temp Acr Part Mand Temp Acr false false false 0 0 1919 0 MODBLIV false 42321 15 B Gingevectomy, With Curett Gingevectomy, With Curett false false false 0 0 1919 0 MODBLIV false 42328 15 B Part Mand Soft Lining Part Mand Soft Lining false false false 0 0 1919 0 MODBLIV false 42330 15 B Part Max&mand Temp Acr Part Max&mand Temp Acr false false false 0 0 1919 0 MODBLIV false 42331 15 B Gingival Fiber Incision,1st Tooth Gingival Fiber Incision,1st Tooth false true false 0 0 1418 0 false 42338 15 B Part Max&mand Soft Lining Part Max&mand Soft Lining false false false 0 0 1919 0 MODBLIV false 42339 15 B Gingival Fiber Incision, Add Tooth Gingival Fiber Incision, Add Tooth false true false 0 0 1418 0 false 42341 15 B Soft Tissue Recontouring for Crown Lengthening, per Tooth Soft Tissue Recontouring for Crown Lengthening, per Tooth false true false 0 0 1919 0 false 42410 15 B Part Max Light Cured Part Max Light Cured false false false 0 0 1919 0 MODBLIV false 42411 15 B Flap Approach w/ Osteoplast, Ostectomy, Per Sextant Flap Approach w/ Osteoplast, Ostectomy, Per Sextant false true false 0 2 0038 0 false 42418 15 B Part Max Perm Acr Part Max Perm Acr false false false 0 0 1919 0 MODBLIV false 42420 15 B Part Mand Light Cured Part Mand Light Cured false false false 0 0 1919 0 MODBLIV false 42421 15 B Flap Approach, w/ Curettage of Osseous, Per Sextant Flap Approach, w/ Curettage of Osseous, Per Sextant false true false 0 2 0038 0 false 42430 15 B Part Max&mand Light Cured Part Max&mand Light Cured false false false 0 0 1919 0 MODBLIV false 42431 15 B Flap Approach,Osseous/Ost Flap Approach,Osseous/Ost false false false 0 0 1919 0 MODBLIV false 42438 15 B Part Max&mand Perm Acr Part Max&mand Perm Acr false false false 0 0 1919 0 MODBLIV false 42441 15 B Flap Approach, Exploraory, Per Site Flap Approach, Exploraory, Per Site false false false 0 0 false 42451 15 B Flap Approach, for Crown Lengthening, Per Site Flap Approach, for Crown Lengthening, Per Site false true false 0 0 1919 0 false 42461 15 B Flap Approach, with curettage of an Osseous Defect about a Failing Implant Flap Approach, with curettage of an Osseous Defect about a Failing Implant false false false 0 0 false 0 42471 15 B Flap Approach, Currettage of a defect and removal of exposed threads, retentive surface or detoxification Flap Approach, Currettage of a defect and removal of exposed threads, retentive surface or detoxification false false false 0 0 false 0 42481 15 B Flap Approach, with Curettage of an Osseous Defect and Osteoplasty about a failing impant. false false false 0 0 false 0 42510 15 B Part Max Lab Proc Part Max Lab Proc false false false 0 0 1919 0 MODBLIV false 42511 15 B Grafts, Soft Tissue, Pedicle, Per Site Grafts, Soft Tissue, Pedicle, Per Site false false false 0 0 false 42512 15 B Periostial Stim. Periostial Stim. false false false 0 0 1919 MODBLIV false 42520 15 B Part Mand Lab Proc. Part Mand Lab Proc. false false false 0 0 1919 0 MODBLIV false 42521 15 B Grafts, Soft Tissue, Pedicle ( coromally positioned ) Per Site Grafts, Soft Tissue, Pedicle ( coromally positioned ) Per Site false false false 0 0 false 42522 15 B Periostial Stim. Periostial Stim. false false false 0 0 1919 MODBLIV false 42531 15 B Grafts, Free Soft Tissue, Per Site Grafts, Free Soft Tissue, Per Site false false false 0 0 false 42536 15 B Grafts, Free Soft Tissue, Adjacent to an Impact Grafts, Free Soft Tissue, Adjacent to an Impact false false false 0 0 false 0 42541 15 B Grafts, Soft Tissue, Pedicle, w/ Free Graft Placed, Per Site Grafts, Soft Tissue, Pedicle, w/ Free Graft Placed, Per Site false false false 0 0 false 42551 15 B Grafts, Free Connective Tissue ( root coverage ), Per Site Grafts, Free Connective Tissue ( root coverage ), Per Site false false false 0 0 false 42556 15 B Grafts, Free Connective Tissue, Adjacent to an Impact Grafts, Free Connective Tissue, Adjacent to an Impact false false false 0 0 false 0 42561 15 B Grafts, Free Connective Tissue ( ridge augmentation ), Per Site Grafts, Free Connective Tissue ( ridge augmentation ), Per Site false false false 0 0 false 42571 15 B Grafts, Connective Tissue Grafts, Connective Tissue false false false 0 0 1919 MODBLIV false 42581 15 B Grafts, Gingival Onlay, F Grafts, Gingival Onlay, F false false false 0 0 1919 0 MODBLIV false 42590 15 B Grafts, Dermal, Onlay, for Ridge Augmenation Grafts, Dermal, Onlay, for Ridge Augmenation false false false 0 0 false 0 42591 15 B Autograft - per site Autograft - per site false false false 0 0 false 0 42592 15 B Allograft - per site + E Allograft - per site + E false false false 0 0 false 0 42600 15 B PERIODONTAL SURGERY, FLAPS, GRAFTS, OSSEOUS TISSUE PERIODONTAL SURGERY, FLAPS, GRAFTS, OSSEOUS TISSUE false false false 0 0 false 0 42610 15 B Part Max On Imp Part Max On Imp false false false 0 0 1919 0 MODBLIV false 42611 15 B Grafts, Osseous, Autograft ( flap entry, closure and donor site ), Per Site Grafts, Osseous, Autograft ( flap entry, closure and donor site ), Per Site false false false 0 0 false 42620 15 B Part Mand On Imp Part Mand On Imp false false false 0 0 1919 0 MODBLIV false 42621 15 B Grafts, Osseous, Autograft ( flap entry and closure ), Per Site Grafts, Osseous, Autograft ( flap entry and closure ), Per Site false false false 0 0 false 42630 15 B Grafts, Osseous, Zenograft (Including Flap Entry and Closure) Grafts, Osseous, Zenograft (Including Flap Entry and Closure) false false false 0 0 false 0 42631 15 B Per Site + E Per Site + E false false false 0 0 false 0 42700 15 B GUIDED TISSUE REGENERATION GUIDED TISSUE REGENERATION false false false 0 0 false 0 42701 15 B Guided Tissue Regeneration - Non-resorbable false false false 0 0 false 0 42702 15 B Guided Tissue Regeneration - Resorbable false false false 0 0 false 0 42703 15 B Guided Tissue Regeneration - Surgical Re-entry false false false 0 0 false 0 42710 15 B Guided Tissue Regeneration - Non-resorbable Membrane - per site + E Guided Tissue Regeneration - Non-resorbable Membrane - per site + E false false false 0 0 false 0 42711 15 B Guided Tissue Regeneration ( including reentry ), Per Site Guided Tissue Regeneration ( including reentry ), Per Site false false false 0 0 false 42712 15 B Guided Tissue Regeneration - Resorbable Membrane Guided Tissue Regeneration - Resorbable Membrane false false false 0 0 false 0 42721 15 B Biomat not incl surg ent/clos Per site false false false 0 0 false 0 42811 15 B Proximal Wedge Prodedure w/ Flap Curettage, Per Site Proximal Wedge Prodedure w/ Flap Curettage, Per Site false false false 0 2 0038 0 false 42819 15 B Proximal Wedge Prodedure w/ Flap Curettage & Ostectomy/Osteoplasty, Per Site Proximal Wedge Prodedure w/ Flap Curettage & Ostectomy/Osteoplasty, Per Site false false false 0 2 0038 0 false 42821 15 B Post Surg Perio Treatment Visit per Dressing Change, 1 Unit Post Surg Perio Treatment Visit per Dressing Change, 1 Unit false false false 0 0 false 42822 15 B Post Surg Perio Treatment Visit per Dressing Change, 2 Units Post Surg Perio Treatment Visit per Dressing Change, 2 Units false false false 0 0 false 42823 15 B Post Surgical Treatment,3 Post Surgical Treatment,3 false false false 0 0 1919 0 MODBLIV false 42829 15 B Post Surgical Treatment,A Post Surgical Treatment,A false false false 0 0 1919 0 MODBLIV false 42831 15 B Pericoronitis/Abscess,1un Pericoronitis/Abscess,1un false false false 0 0 1919 0 MODBLIV false 42832 15 B Pericoronitis/Abscess,2un Pericoronitis/Abscess,2un false false false 0 0 1919 0 MODBLIV false 42833 15 B Pericoronitis/Abscess,3un Pericoronitis/Abscess,3un false false false 0 0 1919 0 MODBLIV false 42834 15 B Pericoronitis Pericoronitis false false false 0 0 1919 0 MODBLIV false 42839 15 B Pericorontis,Abscess,Addi Pericorontis,Abscess,Addi false false false 0 0 1919 0 MODBLIV false 42840 15 B Flap Approach for Creation of Interdental Papillae Flap Approach for Creation of Interdental Papillae false false false 0 0 false 0 42841 15 B Per Site Per Site false false false 0 0 false 0 43000 15 B Closure/Traum /Laceration Closure/Traum /Laceration false false false 0 0 1919 MODBLIV false 43100 15 B Frenectomy Frenectomy false false false 0 0 1919 MODBLIV false 43110 15 B Part Max Lab Proc. Part Max Lab Proc. false false false 0 0 1919 0 MODBLIV false 43111 15 B ' A ' Splint, Per Joint ' A ' Splint, Per Joint false false false 0 0 false 43120 15 B Part Mand Lab Proc. Part Mand Lab Proc. false false false 0 0 1919 0 MODBLIV false 43130 15 B Part Max&mand Lab Proc. Part Max&mand Lab Proc. false false false 0 0 1919 0 MODBLIV false 43210 15 B Acid Etch Joint Restorati Acid Etch Joint Restorati false false false 0 0 1919 0 MODBLIV false 43211 15 B Bonded Joint Restorations, Per Joint Bonded Joint Restorations, Per Joint false false false 0 0 false 43221 15 B Interproximal Enamel Acid Interproximal Enamel Acid false false false 0 0 1919 MODBLIV false 43231 15 B Wire Ligation, Per Joint Wire Ligation, Per Joint false false false 0 0 false 43241 15 B Wire Ligation, Scrylic Covered, Per Joint Wire Ligation, Scrylic Covered, Per Joint false false false 0 0 false 43251 15 B Floss Ligation/Joint Floss Ligation/Joint false false false 0 0 1919 MODBLIV false 43261 15 B Orthodontic Band Splint Orthodontic Band Splint false false false 0 0 1919 0 MODBLIV false 43271 15 B Cast / Sold / Cer / Ply Glss, Splin, Bond, Per Abutment Cast / Sold / Cer / Ply Glss, Splin, Bond, Per Abutment true false false 0 0 false 43279 15 B Remove Per. Splints/Unit Remove Per. Splints/Unit false false false 0 0 1919 MODBLIV false 43281 15 B Removal of Fixed Perio Splints, 1 Unit Removal of Fixed Perio Splints, 1 Unit false false false 0 0 false 43289 15 B Removal of Fixed Perio Splints, Add Unit Removal of Fixed Perio Splints, Add Unit false false false 0 0 false 43311 15 B Occlusal Adjust / Equilibration - 1 Unit Occlusal Adjust / Equilibration - 1 Unit false false false 0 0 false 43312 15 B Occlusal Adjust / Equilibration - 2 Units Occlusal Adjust / Equilibration - 2 Units false false false 0 0 false 43313 15 B Occlusal Adjust / Equilibration - 3 Units Occlusal Adjust / Equilibration - 3 Units false false false 0 0 false 43314 15 B Occlusal Adjust / Equilibration - 4 Units Occlusal Adjust / Equilibration - 4 Units false false false 0 0 false 43317 15 B Occlusal Adjustment / Equilibration - 1/2 Unit of Time Occlusal Adjustment / Equilibration - 1/2 Unit of Time false false false 0 0 43319 15 B Occlusal Adjust / Equilibration - add Unit over 4 Occlusal Adjust / Equilibration - add Unit over 4 false false false 0 0 false 43411 12 R Scaling - 1 unit Scaling - 1 unit false false false 0 0 false 43412 12 R Scaling - 2 units Scaling - 2 units false false false 0 0 false 43413 12 R Scaling - 3 units Scaling - 3 units false false false 0 0 false 43414 12 R Scaling - 4 units Scaling - 4 units false false false 0 0 false 43415 12 R Scaling - 5 units Scaling - 5 units false false false 0 0 false 43416 12 R scaling - 6 units scaling - 6 units false false false 0 0 false 43417 12 R Scaling - 0.5 unit Scaling - 0.5 unit false false false 0 0 false 43419 12 R Scaling - add unit over six Scaling - add unit over six false false false 0 0 false 43421 15 R Root Planing, 1 Unit of time Root Planing, 1 Unit of time false false false 1 0 false 43422 15 R Root Planing, 2 Units of time Root Planing, 2 Units of time false false false 1 0 false 43423 15 R Root Planing, 3 Units of time Root Planing, 3 Units of time false false false 1 0 false 43424 15 R Root Planing, 4 Units of time Root Planing, 4 Units of time false false false 1 0 false 43425 15 R Root Planing, 5 Units of time Root Planing, 5 Units of time false false false 1 0 false 43426 15 R Root Planing, 6 Units of time Root Planing, 6 Units of time false false false 1 0 false 43427 15 R Root Planing, 0.5 Unit of time Root Planing, 0.5 Unit of time false false false 1 0 false 43429 15 R Root Planning, Each additional unit over 6 Root Planning, Each additional unit over 6 false false false 1 0 false 43511 15 B Chemotherapeutic Topical Appli, 1 Unit Chemotherapeutic Topical Appli, 1 Unit false false false 0 0 false 43519 15 B Chemotherapeutic Topical Appli, add Unit Chemotherapeutic Topical Appli, add Unit false false false 0 0 false 43521 15 B Chemotherapuetic Intra - sulcular Appli, 1 Unit Chemotherapuetic Intra - sulcular Appli, 1 Unit false false false 0 0 false 43529 15 B Chemotherapuetic Intra - sulcular Appli, add Unit Chemotherapuetic Intra - sulcular Appli, add Unit false false false 0 0 false 43611 15 B Appli Perio - Max Appli Perio - Max true false false 0 0 false 43612 15 B Appli Perio - Mand Appli Perio - Mand true false false 0 0 false 43621 15 B Appliance, Bruxism Appliance Mainten, Repair - 1 Unit Appliance, Mainten, adj, Appliance, Bruxism Appliance Mainten, Repair - 1 Unit false false false 0 0 43622 15 B Appliance, Bruxism Appliance Mainten, Repair - 2 Units Appliance, Bruxism Appliance Mainten, Repair - 2 Units false false false 0 0 43623 15 B Appliance, Bruxism Appliance Mainten, Repair - 3 Units Appliance, Bruxism Appliance Mainten, Repair - 3 Units false false false 0 0 43629 15 B Appliance, Bruxism Appliance Mainten, Repair - Add Unit Appliance, Bruxism Appliance Mainten, Repair - Add Unit false false false 0 0 43631 15 B Bruxism Appliance - Reline, Direct Bruxism Appliance - Reline, Direct false false false 0 0 43632 15 B Periodontal, Reline, Proc Periodontal, Reline, Proc false false false 0 0 1919 MODBLIV false 43701 15 B Part Max Comp. Mand Part Max Comp. Mand false false false 0 0 1919 0 MODBLIV false 43711 15 B Appliance, TMJ Dianostic - Max Appliance Appliance, TMJ Dianostic - Max Appliance true false false 0 0 false 43712 15 B Appliance, TMJ Dianostic - Mand Appliance Appliance, TMJ Dianostic - Mand Appliance true false false 0 0 false 43721 15 B Appliance, TMJ Intraoral Reposition - Max Appliance Appliance, TMJ Intraoral Reposition - Max Appliance true false false 0 0 false 43722 15 B Appliance, TMJ Intraoral Reposition - Mand Appliance Appliance, TMJ Intraoral Reposition - Mand Appliance true false false 0 0 false 43731 15 B Appliance, TMJ, Perio - Mainten, adj, Repair 1 Unit Appliance, TMJ, Perio - Mainten, adj, Repair 1 Unit true false false 0 0 false 43732 15 B Appliance, TMJ, Perio - Mainten, adj, Repair 2 Units Appliance, TMJ, Perio - Mainten, adj, Repair 2 Units true false false 0 0 false 43733 15 B Adjust Tmj Appliance - 3 Adjust Tmj Appliance - 3 false false false 0 0 1919 0 MODBLIV false 43739 15 B Adjust Tmj Appliance,Addi Adjust Tmj Appliance,Addi false false false 0 0 1919 0 MODBLIV false 43741 15 B Appliance, TMJ, Reline, Direct Appliance, TMJ, Reline, Direct false false false 0 0 43742 15 B Tmj - Reline, Processed Tmj - Reline, Processed false false false 0 0 1919 MODBLIV false 43751 15 B Appl/Tmj/Diag/Imp Sup/Max Appl/Tmj/Diag/Imp Sup/Max false false false 0 0 1919 0 MODBLIV false 43752 15 B Appl/Tmj/Diag/Imp Sup/Man Appl/Tmj/Diag/Imp Sup/Man false false false 0 0 1919 0 MODBLIV false 43759 15 B Appl/Tmj/Diag/Imp Sup/Man Appl/Tmj/Diag/Imp Sup/Man false false false 0 0 1919 0 MODBLIV false 43761 15 B Appl/Tmj/Imp Sup/Adjt/1 U Appl/Tmj/Imp Sup/Adjt/1 U false false false 0 0 1919 0 MODBLIV false 43762 15 B Appl/Tmj/Imp Sup/Adjt/2 U Appl/Tmj/Imp Sup/Adjt/2 U false false false 0 0 1919 0 MODBLIV false 43763 15 B Appl/Tmj/Imp Sup/Adjt/3u Appl/Tmj/Imp Sup/Adjt/3u false false false 0 0 1919 0 MODBLIV false 43769 15 B Appl/Tmj/Imp Sup/Adjt/Add Appl/Tmj/Imp Sup/Adjt/Add false false false 0 0 1919 0 MODBLIV false 43771 15 B Appl/Tmj/Reline Direct Appl/Tmj/Reline Direct false false false 0 0 1919 0 MODBLIV false 43772 15 B Appl/Tmj/Reline Process Appl/Tmj/Reline Process false false false 0 0 1919 0 MODBLIV false 43773 15 B App/Tmj Reline 3 Units App/Tmj Reline 3 Units false false false 0 0 1919 0 MODBLIV false 43781 15 B Appl/Tmj/Reline Direct Appl/Tmj/Reline Direct false false false 0 0 1919 0 MODBLIV false 43782 15 B Appl/Tmj/Reline Processed Appl/Tmj/Reline Processed false false false 0 0 1919 0 MODBLIV false 43801 15 B M.P.S. Appliance-Upper M.P.S. Appliance-Upper false false false 0 0 1919 0 MODBLIV false 43802 15 B M.P.S. Appliance - Lower M.P.S. Appliance - Lower false false false 0 0 1919 0 MODBLIV false 43811 15 B Myofascial Pain Dysfunction Syndrome - Max Applince Myofascial Pain Dysfunction Syndrome - Max Applince true false false 0 0 false 43812 15 B Myofascial Pain Dysfunction Syndrome - Mand Applince Myofascial Pain Dysfunction Syndrome - Mand Applince true false false 0 0 false 43813 15 B Adjust M.P.S. Appliance,3 Adjust M.P.S. Appliance,3 false false false 0 0 1919 0 MODBLIV false 43819 15 B Adjust M.P.S Appliance Adjust M.P.S Appliance false false false 0 0 1919 0 MODBLIV false 43821 15 B 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 43822 15 B 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 43823 15 B Mps, Per. Maintenance, A Mps, Per. Maintenance, A false false false 0 0 1919 0 MODBLIV false 43829 15 B Mps, Maintenance, Adjust Mps, Maintenance, Adjust false false false 0 0 1919 0 MODBLIV false 43831 15 B Appl/Myo/Perio Adj,Rep/1 Appl/Myo/Perio Adj,Rep/1 false false false 0 0 1919 0 MODBLIV false 43832 15 B Appl/Myo/Perio Adj,Rep/2 Appl/Myo/Perio Adj,Rep/2 false false false 0 0 1919 0 MODBLIV false 43833 15 B Appl/Myo/Perio Adj,Rep/3 Appl/Myo/Perio Adj,Rep/3 false false false 0 0 1919 0 MODBLIV false 43839 15 B Appl/Myo/Perio Adj,Rep/Ad Appl/Myo/Perio Adj,Rep/Ad false false false 0 0 1919 0 MODBLIV false 43841 15 B Appl./Myo/Imp Relines,Dir Appl./Myo/Imp Relines,Dir false false false 0 0 1919 0 MODBLIV false 43842 15 B Appl./Myo/Imp Relines,Pro Appl./Myo/Imp Relines,Pro false false false 0 0 1919 0 MODBLIV false 43851 15 B Appl/Myo/Dysf/Perio/Mai 1 Appl/Myo/Dysf/Perio/Mai 1 false false false 0 0 1919 0 MODBLIV false 43852 15 B Appl/Myo/Dysf/Perio/Mai 2 Appl/Myo/Dysf/Perio/Mai 2 false false false 0 0 1919 0 MODBLIV false 43853 15 B Appl/Myo/Dysf/Perio/Mai 3 Appl/Myo/Dysf/Perio/Mai 3 false false false 0 0 1919 0 MODBLIV false 43859 15 B Appl/Myo/Dysf/Perio/Ma Ad Appl/Myo/Dysf/Perio/Ma Ad false false false 0 0 1919 0 MODBLIV false 43861 15 B Appl/Myo/Dysf/Relines Dir Appl/Myo/Dysf/Relines Dir false false false 0 0 1919 0 MODBLIV false 43862 15 B Appl/Myo/Dysf/Relines Pro Appl/Myo/Dysf/Relines Pro false false false 0 0 1919 0 MODBLIV false 43901 15 B Appl/Myofac/Construc/Max Appl/Myofac/Construc/Max false false false 0 0 1919 0 MODBLIV false 43902 15 B Appl/Myofac/Construc/Mand Appl/Myofac/Construc/Mand false false false 0 0 1919 0 MODBLIV false 43911 15 B Appl/Myofac/Imp,Sup/1 Uni Appl/Myofac/Imp,Sup/1 Uni false false false 0 0 1919 0 MODBLIV false 43912 15 B Appl/Myofac/Imp,Sup/2 Uni Appl/Myofac/Imp,Sup/2 Uni false false false 0 0 1919 0 MODBLIV false 43913 15 B Appl/Myofac/Imp,Sup/3 Uni Appl/Myofac/Imp,Sup/3 Uni false false false 0 0 1919 0 MODBLIV false 43919 15 B Appl/Myofac/Imp,Sup/Add Appl/Myofac/Imp,Sup/Add false false false 0 0 1919 0 MODBLIV false 43921 15 B App/Myofac/Reline Direct App/Myofac/Reline Direct false false false 0 0 1919 0 MODBLIV false 44000 15 B Fracture Treatment Fracture Treatment false false false 0 0 1919 MODBLIV false 44110 15 B Part Max Dup Lab Proc Part Max Dup Lab Proc false false false 0 0 1919 0 MODBLIV false 44120 15 B Part Mand Dup Lab Proc Part Mand Dup Lab Proc false false false 0 0 1919 0 MODBLIV false 44130 15 B Part Max&mand Dup Lab Pro Part Max&mand Dup Lab Pro false false false 0 0 1919 0 MODBLIV false 45110 15 B Part Max Remount & Equil Part Max Remount & Equil false false false 0 0 1919 0 MODBLIV false 45120 15 B Part Mand Remount&equil Part Mand Remount&equil false false false 0 0 1919 0 MODBLIV false 45130 15 B Part Max&mand Remount&equ Part Max&mand Remount&equ false false false 0 0 1919 0 MODBLIV false 45210 15 B Part Max Reset Part Max Reset false false false 0 0 1919 0 MODBLIV false 45230 15 B Part Max&mand Reset Part Max&mand Reset false false false 0 0 1919 0 MODBLIV false 46110 15 B Part Max Repair No Imp Part Max Repair No Imp false false false 0 0 1919 0 MODBLIV false 46120 15 B Part Mand Repair No Imp Part Mand Repair No Imp false false false 0 0 1919 0 MODBLIV false 46210 15 B Repair Part Max With Imp Repair Part Max With Imp false false false 0 0 1919 0 MODBLIV false 46220 15 B Repair Part Mand With Imp Repair Part Mand With Imp false false false 0 0 1919 0 MODBLIV false 46310 15 B Part Max Add Teeth/Clasp Part Max Add Teeth/Clasp false false false 0 0 1919 0 MODBLIV false 46320 15 B Part Mand Add Teeth/Clasp Part Mand Add Teeth/Clasp false false false 0 0 1919 0 MODBLIV false 47110 15 B Tissue Cond Part Max Tissue Cond Part Max false false false 0 0 1919 0 MODBLIV false 47120 15 B Tissue Cond Part Mand Tissue Cond Part Mand false false false 0 0 1919 0 MODBLIV false 47779 15 B App/Tmj Reline Add Units App/Tmj Reline Add Units false false false 0 0 1919 0 MODBLIV false 48110 15 B Adj Part Max Adj Part Max false false false 0 0 1919 0 MODBLIV false 48111 15 B Adj (lllt) Part Max Adj (lllt) Part Max false false false 0 0 1919 0 MODBLIV false 48120 15 B Adj Part Mand Adj Part Mand false false false 0 0 1919 0 MODBLIV false 48121 15 B Adj (lllt) Part Mand Adj (lllt) Part Mand false false false 0 0 1919 0 MODBLIV false 49101 15 B Perio Evaluation, 1 Unit Perio Evaluation, 1 Unit false false false 0 0 false 49102 15 B Perio Evaluation, 2 Units Perio Evaluation, 2 Units false false false 0 0 false 49109 15 B Perio Evaluation, add Unit over 2 Perio Evaluation, add Unit over 2 false false false 0 0 false 49211 15 B Perio Irrigation, Subgingival, 1 Unit Perio Irrigation, Subgingival, 1 Unit false false false 0 0 false 49219 15 B Perio Irrigation, Subgingival, Add Unit Perio Irrigation, Subgingival, Add Unit false false false 0 0 false 49221 15 B Periodontal Irrigation about Implants, Subgingival Periodontal Irrigation about Implants, Subgingival false false false 0 0 false 0 49229 15 B Additional unit, Periodontal Irrigation about Implants, Subgingival Additional unit, Periodontal Irrigation about Implants, Subgingival false false false 0 0 false 0 50000 16 M false false false 0 0 1919 0 MODBLIV 0 false 0 51101 16 M Complete Dentures, Standard - Maxillary Complete Dentures, Standard - Maxillary true false false 0 0 false 51102 16 M Complete Dentures Standard, Mandibular Complete Dentures Standard, Mandibular true false false 0 0 false 51103 16 M Complete Dentures Standard, Max plus mandibular Complete Dentures Standard, Max plus mandibular true false false 0 0 false 51104 16 M Complete Dentures Standard, Liners, Processed, Resilient, in Add Complete Dentures Standard, Liners, Processed, Resilient, in Add false false false 0 0 false 51201 16 M Complete Dentures Complex, Maxillary Complete Dentures Complex, Maxillary true false false 0 0 false 51202 16 M Complete Dentures Complex, Mandibular Complete Dentures Complex, Mandibular true false false 0 0 false 51203 16 M Dentures,Max+Mand (comb) Dentures,Max+Mand (comb) false false false 0 0 1919 MODBLIV false 51204 16 M Complete Dentures Complex, Liners, Processed, Resilient, in Add Complete Dentures Complex, Liners, Processed, Resilient, in Add false false false 0 0 false 51301 16 M Dentures, Surgical, Standard (Immediate) - Max Dentures, Surgical, Standard ( Immed ) - Max true false false 0 0 false 51302 16 M Dentures, Surgical, Standard Immediate) - Mand Dentures, Surgical, Standard ( Immediate ) - Mand true false false 0 0 false 51303 16 M Dentures, Surgical, Standard (Immediate) - Max & Mand Dentures, Surgical, Standard (Immediate) - Max & Mand false false false 0 0 false 51401 16 M Denture/Surg/Maxillary Denture/Surg/Maxillary false false false 0 0 1919 MODBLIV false 51402 16 M Denture/Surg/Mandibular Denture/Surg/Mandibular false false false 0 0 1919 MODBLIV false 51403 16 M Denture/Surg/Max+Mand Denture/Surg/Max+Mand false false false 0 0 1919 0 MODBLIV false 51501 16 M Dentures,Comp,Maxillary Dentures,Comp,Maxillary false false false 0 0 1919 MODBLIV false 51502 16 M Dentures,Compl,Manibular Dentures,Compl,Manibular false false false 0 0 1919 MODBLIV false 51503 16 M Dentures,Comp/Max+Mand Dentures,Comp/Max+Mand false false false 0 0 1919 0 MODBLIV false 51601 16 M Dentures, Complete, Provisional - Maxillary Dentures, Complete, Provisional - Maxillary true false false 0 0 false 51602 16 M Dentures, Complete, Provisional - Mandibular Dentures, Complete, Provisional - Mandibular true false false 0 0 false 51603 16 M Dentures, Complete, Provisional - Max + Mand Dentures, Complete, Provisional - Max + Mand true false false 0 0 false 51701 16 M Dent/Comp/Over Maxillary Dent/Comp/Over Maxillary false false false 0 0 1919 0 MODBLIV false 51702 16 M Dent/Comp/Over Mandibular Dent/Comp/Over Mandibular false false false 0 0 1919 0 MODBLIV false 51703 16 M Dent/Comp/Over Max+Mand Dent/Comp/Over Max+Mand false false false 0 0 1919 0 MODBLIV false 51711 16 M Overdenture, Natural Teeth - Maxillary Overdenture, Natural Teeth - Maxillary true false false 0 0 false 51712 16 M Overdenture Supported by Natural Teeth-Mandibular Overdenture Supported by Natural Teeth-Mandibular true false false 0 0 false 51713 16 M Dentures, Complete, Overdenture Supported by Natural Teeth - Max + Mand Dentures, Complete, Overdenture Supported by Natural Teeth - Max + Mand true false false 0 0 false 51721 22 M Denture Removal, Implant - Max Denture Removal, Implant - Max true true false 0 3 0011 0 false 51722 22 M Denture Removal, Implant - Mand Denture Removal, Implant - Maxnd true true false 0 3 0022 0 false 51723 16 M Dent/Comp/Over/Max+Mand Dent/Comp/Over/Max+Mand false false false 0 0 1919 0 MODBLIV false 51731 22 M Denture Removal, Combine - Max Denture Removal, Combine - Max true true false 0 3 0011 0 false 51732 22 M Denture Removal , Combine - Mand Denture Removal, Combine - Mand true true false 0 3 0022 0 false 51733 16 M Dent Comp Over/No/Max+Man Dent Comp Over/No/Max+Man false false false 0 0 1919 0 MODBLIV false 51801 16 M Comp/Over/Immed Maxillary Comp/Over/Immed Maxillary false false false 0 0 1919 0 MODBLIV false 51802 16 M Comp/Over/Immed Mandibula Comp/Over/Immed Mandibula false false false 0 0 1919 0 MODBLIV false 51803 16 M Comp/Over/Immed Max+Mand Comp/Over/Immed Max+Mand false false false 0 0 1919 0 MODBLIV false 51811 16 M Denture Removal - Max Denture Removal - Max true false false 0 0 false 51812 16 M Denture Removal - Mand Denture Removal - Mand true false false 0 0 false 51813 16 M Dentures,Complete, Overdentures Supported by Natural Teeth - Max + Mand Dentures,Complete, Overdentures Supported by Natural Teeth - Max + Mand true false false 0 0 false 51821 22 M Denture Removal ( Immed ) Implant - Max Denture Removal ( Immed ) Implant - Max true true false 0 3 0011 0 false 51822 22 M Denture Removal ( Immed ) Implant - Mand Denture Removal ( Immed ) Implant - Mand true true false 0 3 0022 0 false 51823 16 M Dent Comp/Supp,Nat/Max &m Dent Comp/Supp,Nat/Max &m false false false 0 0 1919 0 MODBLIV false 51831 22 M Denture Removal ( Immed ) Combine - Max Denture Removal ( Immed ) Combine - Max true true false 0 3 0011 0 false 51832 22 M Denture Removal ( Immed ) Combine - Mand Denture Removal ( Immed ) Combine - Mand true true false 0 3 0022 0 false 51833 16 M Dent Comp/Supp Comb/Max & Dent Comp/Supp Comb/Max & false false false 0 0 1919 0 MODBLIV false 51911 16 M Denture w/ Indepen Attach - Max Denture w/ Indepen Attach - Max true false false 0 0 false 51912 16 M Denture w/ Indepen Attach - Mand Denture w/ Indepen Attach - Mand true false false 0 0 false 51913 16 M Dentures,Complete, Overdentures W/ Independent Attachments - Max + Mand Dentures,Complete, Overdentures W/ Independent Attachments - Max + Mand true false false 0 0 false 51921 16 M Denture w/ Indepen Attach, Implant - Max Denture w/ Indepen Attach, Implant - Max true false false 0 0 false 51922 16 M Denture w/ Indepen Attach, Implant - Mand Denture w/ Indepen Attach, Implant - Mand true false false 0 0 false 51923 16 M Denture w/ Indepen Attach, Implant - Max + Mand Denture w/ Indepen Attach, Implant - Max + Mand true false false 0 0 false 51931 22 M Denture w/ Indepen Attach, Combin - Max Denture w/ Indepen Attach, Combin - Max true true false 0 3 0011 0 false 51932 22 M Denture w/ Indepen Attach, Combin - Mand Denture w/ Indepen Attach, Combin - Mand true true false 0 3 0022 0 false 51933 16 M Dent/Comp,Over/ Max+Mand Dent/Comp,Over/ Max+Mand false false false 0 0 1919 0 MODBLIV false 51941 22 M Denture w/ Retentive Bar ( Coping Crowns ) - Max Denture w/ Retentive Bar ( Coping Crowns ) - Max true true false 0 3 0011 0 false 51942 22 M Denture w/ Retentive Bar ( Coping Crowns ) - Mand Denture w/ Retentive Bar ( Coping Crowns ) - Mand true true false 0 3 0022 0 false 51943 16 M Dent/Comp,Over/Nat/Max&ma Dent/Comp,Over/Nat/Max&ma false false false 0 0 1919 0 MODBLIV false 51951 16 M Denture w/ Retentive Bar ( Coping Crowns ) Implant - Max Denture w/ Retentive Bar ( Coping Crowns ) Implant - Max true false false 0 0 false 51952 16 M Denture w/ Retentive Bar ( Coping Crowns ) Implant - Mand Denture w/ Retentive Bar ( Coping Crowns ) Implant - Mand true false false 0 0 false 51953 16 M Denture w/ Retentive Bar ( Coping Crowns ) Implant - Max + Mand Denture w/ Retentive Bar ( Coping Crowns ) Implant - Max + Mand true false false 0 0 false 51961 22 M Denture w/ Retentive Bar ( Coping Crowns ) Combin - Max Denture w/ Retentive Bar ( Coping Crowns ) Combin - Max true true false 0 3 0011 0 false 51962 22 M Denture w/ Retentive Bar ( Coping Crowns ) Combin - Maxnd Denture w/ Retentive Bar ( Coping Crowns ) Combin - Mand true true false 0 3 0022 0 false 51963 16 M Dent/Comp/Over,Comb,Max&m Dent/Comp/Over,Comb,Max&m false false false 0 0 1919 0 MODBLIV false 52101 16 M Denture, Partial - Maxillary Denture, Partial - Maxillary true false false 0 0 false 52102 16 M Denture, Partial - Mandibular Denture, Partial - Mandibular true false false 0 0 false 52103 16 M Part/Acryl/Trans Max+Mand Part/Acryl/Trans Max+Mand false false false 0 0 1919 0 MODBLIV false 52111 16 M Partial Upper Denture Partial Upper Denture false false false 0 0 1919 0 MODBLIV false 52112 16 M Partial Lower Denture Partial Lower Denture false false false 0 0 1919 0 MODBLIV false 52113 16 M Part/Acryl/Immed Max+Mand Part/Acryl/Immed Max+Mand false false false 0 0 1919 0 MODBLIV false 52121 16 M false false false 0 0 1919 0 MODBLIV 0 false 0 52201 16 M Denture, Partial, Resilient Retaine r- Maxillary Denture, Partial, Resilient Retainer - Maxillary true false false 0 0 false 52202 16 M Denture, Partial, Resilient Retainer - Mandibular Denture, Partial, Resilient Retainer - Mandibular true false false 0 0 false 52203 16 M Part/Acryl/Resil Max+Mand Part/Acryl/Resil Max+Mand false false false 0 0 1919 0 MODBLIV false 52211 16 M Denture, Partial, Acrylic, Resilient Retainer (Immediate) - Maxillary Denture, Partial, Acrylic, Resilient Retainer (Immediate) - Maxillary true false false 0 0 false 52212 16 M Denture, Partial, Acrylic, Resilient Retainer (Immediate) - Mandibular Denture, Partial, Acrylic, Resilient Retainer (Immediate) - Mandibular true false false 0 0 false 52213 16 M Acryl/Resil/Immed Max+Man Acryl/Resil/Immed Max+Man false false false 0 0 1919 0 MODBLIV false 52301 16 M Denture, Partial, w/ Metal Wrought / Cast Clasps - Max Denture, Partial, w/ Metal Wrought / Cast Clasps - Max true false false 0 0 false 52302 16 M Denture, Partial, w/ Metal Wrought / Cast Clasps - Mand Denture, Partial, w/ Metal Wrought / Cast Clasps - Mand true false false 0 0 false 52303 16 M Denture, Partial, w/ Metal Wrought / Cast Clasps - Max + Mand Denture, Partial, w/ Metal Wrought / Cast Clasps - Max +Mand true false false 0 0 false 52311 16 M Denture, Partial, w/ Metal Wrought / Cast Clasps (Immediate) - Max Denture, Partial, w/ Metal Wrought / Cast Clasps (Immediate) - Max true false false 0 0 false 52312 16 M Denture, Partial, w/ Metal Wrought / Cast Clasps (Immediate) - Mand Denture, Partial, w/ Metal Wrought / Cast Clasps (Immediate) - Mand true false false 0 0 false 52313 16 M Acryl/Metal/Immed Max+Man Acryl/Metal/Immed Max+Man false false false 0 0 1919 0 MODBLIV false 52401 16 M Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps - Max Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps - Max true false false 0 0 false 52402 16 M Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps - Mand Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps - Mand true false false 0 0 false 52403 16 M Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps - Max + Mand Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps - Max + Mand true false false 0 0 false 52411 16 M Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps (Immediate) - Max Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps (Immediate) - Max true false false 0 0 false 52412 16 M Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps (Immediate) - Mand Denture, Partial, w/ Metal Wrought Palatal / Lingual Bar & Clasps (Immediate) - Mand true false false 0 0 false 52413 16 M Metal Bar/Immed Max+Mand Metal Bar/Immed Max+Mand false false false 0 0 1919 0 MODBLIV false 52501 16 M Over/Acryl Maxillary Over/Acryl Maxillary false false false 0 0 1919 0 MODBLIV false 52502 16 M Over/Acryl Mandibular Over/Acryl Mandibular false false false 0 0 1919 0 MODBLIV false 52503 16 M Over/Acryl Max+Mand Over/Acryl Max+Mand false false false 0 0 1919 0 MODBLIV false 52511 16 M Denture, Partial ( Flexible Acrylic ) - Maxillary Denture, Partial ( Flexible Acrylic ) - Maxillary true false false 0 0 false 52512 16 M Denture, Partial ( Flexible Acrylic ) - Mandibular Denture, Partial ( Flexible Acrylic ) - Mandibular true false false 0 0 false 52513 16 M Over/Acryl/Immed Max+Mand Over/Acryl/Immed Max+Mand false false false 0 0 1919 0 MODBLIV false 52711 16 M Denture, Partial, w/ Cast / Wrot Clasp - Max Denture, Partial, w/ Cast / Wrot Clasp - Max true false false 0 0 false 52712 16 M Denture, Partial, w/ Cast / Wrot Clasp - Mand Denture, Partial, w/ Cast / Wrot Clasp - Mand true false false 0 0 false 52713 16 M Dentures, Partial, Overdentures,Acrylic, W/ Cast/ Wrot Clasp/ &Rest Support - Max + Mand Dentures, Partial, Overdentures,Acrylic, W/ Cast/ Wrot Clasp/ &Rest Support - Max + Mand true false false 0 0 false 52721 22 M Implant Denture, Partial, w/ Cast / Wrot Clasp - Max Implant Denture, Partial, w/ Cast / Wrot Clasp - Max true true false 0 3 0011 0 false 52722 22 M Dent, Partial, Overdent w/ Cast / Wrot Clasp - Mand Dent, Partial, Overdent w/ Cast / Wrot Clasp - Mand true true false 0 3 0022 0 false 52723 16 M Dent/Part/Imp/Cwn/Max&man Dent/Part/Imp/Cwn/Max&man false false false 0 0 1919 0 MODBLIV false 52731 22 M Dent, Partial, Overdent ( Immed ) w/ Cast Wrot Clasp, Combin - Max Dent, Partial, Overdent ( Immed ) w/ Cast Wrot Clasp, Combin - Max true true false 0 3 0011 0 false 52732 22 M Dent, Partial, Overdent ( Immed ) w/ Cast Wrot Clasp, Combin - Mand Dent, Partial, Overdent ( Immed ) w/ Cast Wrot Clasp, Combin - Mand true true false 0 3 0022 0 false 52733 16 M Dent/Part/Comb/Cwn/Max&ma Dent/Part/Comb/Cwn/Max&ma false false false 0 0 1919 0 MODBLIV false 52811 16 M Dent, Partial, Overdent ( Immed ) w/ Cast / Wrought Clap - Max Dent, Partial, Overdent ( Immed ) w/ Cast / Wrought Clap - Max true false false 0 0 false 52812 16 M Dent, Partial, Overdent ( Immed ) w/ Cast / Wrought Clap - Mand Dent, Partial, Overdent ( Immed ) w/ Cast / Wrought Clap - Mand true false false 0 0 false 52813 16 M Dentures, Partial, Overdentures( Immediate ) W/ Cast/ Wrought Clap & Rest Support - Max + Mand Dentures, Partial, Overdentures( Immediate ) W/ Cast/ Wrought Clap & Rest Support - Max + Mand true false false 0 0 false 52821 22 M Implant Dent, Partial, Overdent ( Immed ) Acrylic, w/ Cast / Wrot Clasp - Max Implant Dent, Partial, Overdent ( Immed ) Acrylic, w/ Cast / Wrot Clasp - Max true true false 0 3 0011 0 false 52822 22 M Implant Denture, Partial ( Immed ) Acrylic, w/ Cast / Wrot Clasp - Mand Implant Denture, Partial ( Immed ) Acrylic, w/ Cast / Wrot Clasp - Mand true true false 0 3 0022 0 false 52823 16 M Dent/Part/Immed/Imp/Max&m Dent/Part/Immed/Imp/Max&m false false false 0 0 1919 0 MODBLIV false 52831 22 M Denture, Partial ( Immed ) ,Acrlic, w/ Cast / Wrot Clasp, Combin - Max Denture, Partial ( Immed ) ,Acrlic, w/ Cast / Wrot Clasp, Combin - Max true true false 0 3 0011 0 false 52832 22 M Denture, Partial ( Immed ) ,Acrlic, w/ Cast / Wrot Clasp, Combin - Mand Denture, Partial ( Immed ) ,Acrlic, w/ Cast / Wrot Clasp, Combin - Mand true true false 0 3 0022 0 false 52833 16 M Dent/Part/Immed/Comb/Max& Dent/Part/Immed/Comb/Max& false false false 0 0 1919 0 MODBLIV false 52911 16 M Denture, Partial, w/ Indepent Attach - Max Denture, Partial, w/ Indepent Attach - Max true false false 0 0 false 52912 16 M Denture, Partial, w/ Indepent Attach - Mant Denture, Partial, w/ Indepent Attach - Mant true false false 0 0 false 52913 16 M Dentures, Partial, W/ Cast / Wrought Clasp & Rest W/ Attach - Max + Mand Dentures, Partial, W/ Cast / Wrought Clasp & Rest W/ Attach - Max + Mand true false false 0 0 false 52921 22 M Denture, Partial, w/ Indepent Attach, Implant - Max Denture, Partial, w/ Indepent Attach, Implant - Max true true false 0 3 0011 0 false 52922 22 M Denture, Partial, w/ Indepent Attach, Implant - Mand Denture, Partial, w/ Indepent Attach, Implant - Mand true true false 0 3 0022 0 false 52923 16 M Dent/Part/Ind/Att/Imp/M&m Dent/Part/Ind/Att/Imp/M&m false false false 0 0 1919 0 MODBLIV false 52931 22 M Denture, Partial, w/ Indepent Attach, Combin - Max Denture, Partial, w/ Indepent Attach, Combin - Max true true false 0 3 0011 0 false 52932 22 M Denture, Partial, w/ Indepent Attach, Combin - Mand Denture, Partial, w/ Indepent Attach, Combin - Mand true true false 0 3 0022 0 false 52933 16 M Dent/Part/Ind/Att/Com/M&m Dent/Part/Ind/Att/Com/M&m false false false 0 0 1919 0 MODBLIV false 52941 16 M Denture, Partial w/ Rentention - Max Denture, Partial w/ Rentention - Max true false false 0 0 false 52942 16 M Denture, Partial w/ Rentention - Mand Denture, Partial w/ Rentention - Mand true false false 0 0 false 52943 16 M Dentures, Partial, W/ Cast/Wrot Clasp & Rest W/Rentention - Max + Mand Dentures, Partial, W/ Cast/Wrot Clasp & Rest W/Rentention - Max + Mand true false false 0 0 false 52951 22 M Denture, Partial w/ Retention ( Coping Crown ) Implant - Max Denture, Partial w/ Retention ( Coping Crown ) Implant - Max true true false 0 3 0011 0 false 52952 22 M Denture, Partial w/ Retention ( Coping Crown ) Implant - Mand Denture, Partial w/ Retention ( Coping Crown ) Implant - Mand true true false 0 3 0022 0 false 52953 16 M Dent/Part/Reten/Imp/Max&m Dent/Part/Reten/Imp/Max&m false false false 0 0 1919 0 MODBLIV false 52961 22 M Denture, Partial w/ Retention ( Coping Crown ) Combine - Max Denture, Partial w/ Retention ( Coping Crown ) Combine - Max true true false 0 3 0011 0 false 52962 22 M Denture, Partial, w/ Retention ( Coping Crown ) Combine - Mand Denture, Partial, w/ Retention ( Coping Crown ) Combine - Mand true true false 0 3 0022 0 false 52963 16 M Dent/Part/Reten/Comb/M&m Dent/Part/Reten/Comb/M&m false false false 0 0 1919 0 MODBLIV false 53101 16 M Denture, Partial, Cast Free End, Frame / Connect Clasp - Max Denture, Partial, Cast Free End, Frame / Connect Clasp - Max true false false 0 0 false 53102 16 M Denture, Partial, Cast Free End, Frame / Connect Clasp - Mand Denture, Partial, Cast Free End, Frame / Connect Clasp - Mand true false false 0 0 false 53103 16 M Free End/Cast Max+Mand Free End/Cast Max+Mand false false false 0 0 1919 0 MODBLIV false 53104 16 M Denture, Partial, Cast Free End, Frame / Connect Clasp, Impression Denture, Partial, Cast Free End, Frame / Connect Clasp, Impression true false false 0 0 false 53111 16 M Partial Upper Dent-Immedi Partial Upper Dent-Immedi false false false 0 0 1919 0 MODBLIV false 53112 16 M Partial Lower Dent-Immedi Partial Lower Dent-Immedi false false false 0 0 1919 0 MODBLIV false 53113 16 M Free End/Immed Max+Mand Free End/Immed Max+Mand false false false 0 0 1919 0 MODBLIV false 53121 16 M Dentire/Part Free/Max Dentire/Part Free/Max false false false 0 0 1919 MODBLIV false 53122 16 M Denture/Part Free/Mand Denture/Part Free/Mand false false false 0 0 1919 MODBLIV false 53123 16 M Dent,Swing Lock,Max +Mand Dent,Swing Lock,Max +Mand false false false 0 0 1919 MODBLIV false 53131 16 M Dentures,Part,Maxillary Dentures,Part,Maxillary false false false 0 0 1919 MODBLIV false 53132 16 M Dentures,Part,Mandibular Dentures,Part,Mandibular false false false 0 0 1919 MODBLIV false 53133 16 M Dentures,Part,Max & Mand Dentures,Part,Max & Mand false false false 0 0 1919 0 MODBLIV false 53201 16 M Denture, Partial, Tooth Borne, Cast Frame /Connector, Clasp - Max Denture, Partial, Tooth Borne, Cast Frame /Connector, Clasp - Max true false false 0 0 false 53202 16 M Denture, Partial, Tooth Borne, Cast Frame /Connector, Clasp - Mand Denture, Partial, Tooth Borne, Cast Frame /Connector, Clasp - Mand true false false 0 0 false 53203 16 M Denture, Partial, Tooth Borne, Cast Frame /Connector, Clasp - Max + Mand Denture, Partial, Tooth Borne, Cast Frame /Connector, Clasp - Max + Mand true false false 0 0 false 53205 16 M Denture, Partial, Tooth Borne, Cast Frame / Connect, Clasps - Unilateral, 1 Piece Denture, Partial, Tooth Borne, Cast Frame / Connect, Clasps - Unilateral, 1 Piece true false false 0 0 false 53211 16 M Partial Upper Dent-Immedi Partial Upper Dent-Immedi false false false 0 0 1919 0 MODBLIV false 53212 16 M Partial Lower Dent-Immedi Partial Lower Dent-Immedi false false false 0 0 1919 0 MODBLIV false 53213 16 M Tooth Born/Immed Max+Mand Tooth Born/Immed Max+Mand false false false 0 0 1919 0 MODBLIV false 53215 16 M Unilateral Partial Dent-I Unilateral Partial Dent-I false false false 0 0 1919 0 MODBLIV false 53221 16 M Denture/Partial/Max Denture/Partial/Max false false false 0 0 1919 MODBLIV false 53222 16 M Denture/Partial/Mand. Denture/Partial/Mand. false false false 0 0 1919 MODBLIV false 53223 16 M Dent,Clasp,Equil,Max+Mand Dent,Clasp,Equil,Max+Mand false false false 0 0 1919 MODBLIV false 53301 16 M Part/Cast/Acryl Maxillary Part/Cast/Acryl Maxillary false false false 0 0 1919 0 MODBLIV false 53302 16 M Part/Cast/Acryl Mandibula Part/Cast/Acryl Mandibula false false false 0 0 1919 0 MODBLIV false 53304 16 M Part/Cast/Acryl Altered Part/Cast/Acryl Altered false false false 0 0 1919 0 MODBLIV false 53401 16 M Denture, Partial, Cast, Precision Attach - Max Denture, Partial, Cast, Precision Attach - Max true false false 0 0 false 53402 16 M Denture, Partial, Cast, Precision Attach - Mand Denture, Partial, Cast, Precision Attach - Mand true false false 0 0 false 53403 16 M Denture, Partial, Cast, Precision Attach - Max + Mand Denture, Partial, Cast, Precision Attach - Max + Mand true false false 0 0 false 53404 16 M Part/Cast/Prec/Altered Part/Cast/Prec/Altered false false false 0 0 1919 0 MODBLIV false 53501 16 M Part/Cast/S-Prec Maxillar Part/Cast/S-Prec Maxillar false false false 0 0 1919 0 MODBLIV false 53502 16 M Part/Cast/S-Prec Mandibul Part/Cast/S-Prec Mandibul false false false 0 0 1919 0 MODBLIV false 53503 16 M Part/Cast/S-Prec Max+Mand Part/Cast/S-Prec Max+Mand false false false 0 0 1919 0 MODBLIV false 53504 16 M Part/Cast/S-Prec/Altered Part/Cast/S-Prec/Altered false false false 0 0 1919 0 MODBLIV false 53611 16 M Denture, Cast, Partial, Stress Breaker Attach ( Resilient ) - Max Denture, Cast, Partial, Stress Breaker Attach ( Resilient ) - Max true false false 0 0 false 53612 16 M Partial, Cast, Stress Br Partial, Cast, Stress Br false false false 0 0 1919 0 MODBLIV false 53613 16 M Partial, Cast, Stress Br Partial, Cast, Stress Br false false false 0 0 1919 0 MODBLIV false 53614 16 M Max/Stress Break Altered Max/Stress Break Altered false false false 0 0 1919 0 MODBLIV false 53621 16 M Denture, Cast, Partial, Stress Breaker Attach ( Resilient ) Mand Denture, Cast, Partial, Stress Breaker Attach ( Resilient ) Mand true false false 0 0 false 53622 16 M Partial, Cast, Stress Br Partial, Cast, Stress Br false false false 0 0 1919 0 MODBLIV false 53623 16 M Partial, Cast, Stress Br Partial, Cast, Stress Br false false false 0 0 1919 0 MODBLIV false 53624 16 M Mand/Stress Break Altered Mand/Stress Break Altered false false false 0 0 1919 0 MODBLIV false 53701 16 M Over/Removable Maxillary Over/Removable Maxillary false false false 0 0 1919 0 MODBLIV false 53702 16 M Over/Removable Mandibular Over/Removable Mandibular false false false 0 0 1919 0 MODBLIV false 53703 16 M Over/Removable Max+Mand Over/Removable Max+Mand false false false 0 0 1919 0 MODBLIV false 53704 16 M Over/Removable Altered Over/Removable Altered false false false 0 0 1919 0 MODBLIV false 53711 16 M Dent, Partial, Cast, Overdent, - Max Dent, Partial, Cast, Overdent, - Max true false false 0 0 false 53712 16 M Dent, Partial, Cast, Overdent, - Mand Dent, Partial, Cast, Overdent, - Mand true false false 0 0 false 53713 16 M Denture, Partial Supported by Natural Teeth, No Attach - Max + Mand Denture, Partial Supported by Natural Teeth, No Attach - Max + Mand true false false 0 0 false 53714 16 M Dent, Partial, Cast, Overdent, Altered Cast Impression Dent, Partial, Cast, Overdent, Altered Cast Impression true false false 0 0 false 53721 22 M Dent, Partial, Cast, Overdent, Implant - Max Dent, Partial, Cast, Overdent, Implant - Max true true false 0 3 0011 0 false 53722 22 M Dent, Partial, Cast, Overdent, Implant - Mand Dent, Partial, Cast, Overdent, Implant - Mand true true false 0 3 0022 0 false 53723 16 M Dent/Cast/Imp/No Att/Ma&m Dent/Cast/Imp/No Att/Ma&m false false false 0 0 1919 0 MODBLIV false 53724 22 M Dent, Partial, Cast, Overdent, Implant - Altered Impression Dent, Partial, Cast, Overdent, Implant - Altered Impression true false false 0 0 false 53731 22 M Dent, Partial, Cast, Overdent, Combine - Max Dent, Partial, Cast, Overdent, Combine - Max true true false 0 3 0011 0 false 53732 22 M Dent, Partial, Cast, Overdent, Combine - Mand Dent, Partial, Cast, Overdent, Combine - Mand true true false 0 3 0022 0 false 53733 16 M Dent/Cast/Nat/No Att/Max& Dent/Cast/Nat/No Att/Max& false false false 0 0 1919 0 MODBLIV false 53734 22 M Dent, Partial, Cast, Overdent, Combin - Altered Impression Dent, Partial, Cast, Overdent, Combin - Altered Impression true false false 0 0 false 53811 16 M Dent, Partial, Cast, Overdent ( Immed ) - Maxillary Dent, Partial, Cast, Overdent ( Immed ) - Maxillary true false false 0 0 false 53812 16 M Dent, Partial, Cast, Overdent ( Immed ) - Mand Dent, Partial, Cast, Overdent ( Immed ) - Mand true false false 0 0 false 53813 16 M Denture,Partial,Cast,Overdent, (Immed),Support by Natural Teeth,No Attach-Max + Mand Denture,Partial,Cast,Overdent, (Immed),Support by Natural Teeth,No Attach-Max + Mand true false false 0 0 false 53814 16 M Dent, Partial, Cast, Overdent, ( Immed ) - Altered Cast Imprssion Dent, Partial, Cast, Overdent, ( Immed ) - Altered Cast Imprssion true false false 0 0 false 53821 22 M Dent, Partial, Cast, Overdent ( Immed ) Implant - Max Dent, Partial, Cast, Overdent ( Immed ) Implant - Max true true false 0 3 0011 0 false 53822 22 M Dent, Partial, Cast, Overdent ( Immed ) Implant - Mand Dent, Partial, Cast, Overdent ( Immed ) Implant - Mand true true false 0 3 0022 0 false 53823 16 M Dent/Cast/Immed/Imp/Max&m Dent/Cast/Immed/Imp/Max&m false false false 0 0 1919 0 MODBLIV false 53824 22 M Dent, Partial, Cast, Overdent ( Immed ) Implant - Altered Impression Dent, Partial, Cast, Overdent ( Immed ) Implant - Altered Impression true false false 0 0 false 53831 22 M Dent, Partial, Cast, Overdent ( Immed ) Combin - Max Dent, Partial, Cast, Overdent ( Immed ) Combin - Max true true false 0 3 0011 0 false 53832 22 M Dent, Partial, Cast, Overdent ( Immed ) Combin - Mand Dent, Partial, Cast, Overdent ( Immed ) Combin - Mand true true false 0 3 0022 0 false 53833 16 M Dent/Cast/Immed/Comb/Max& Dent/Cast/Immed/Comb/Max& false false false 0 0 1919 0 MODBLIV false 53834 22 M Dent, Partial, Cast, Overdent ( Immed ) Combin - Altered Impression Dent, Partial, Cast, Overdent ( Immed ) Combin - Altered Impression true false false 0 0 false 53911 16 M Dent, Partial, Cast, Overdent, w/ Indepent Attach - Max Dent, Partial, Cast, Overdent, w/ Indepent Attach - Max true false false 0 0 false 53912 16 M Dent, Partial, Cast, Overdent, w/ Indepent Attach - Mand Dent, Partial, Cast, Overdent, w/ Indepent Attach - Mand true false false 0 0 false 53913 16 M Denture,Partial,Cast,Overdent,W/Independent Attach to Natural Teeth-Max + Mand Denture,Partial,Cast,Overdent,W/Independent Attach to Natural Teeth-Max + Mand true false false 0 0 false 53914 16 M Dent/Cast/Indep/Nat/Alt Dent/Cast/Indep/Nat/Alt false false false 0 0 1919 0 MODBLIV false 53921 16 M Dent. Partial. Cast. Overdent w/ Indepent Attach, Implant - Max Dent, Partial, Cast, Overdent, w/ Indepent Attach, Implant - Max true false false 0 0 false 53922 16 M Dent. Partial. Cast. Overdent w/ Indepent Attach, Implant - Mand Dent. Partial. Cast. Overdent w/ Indepent Attach, Implant - Mand true false false 0 0 false 53923 16 M Dent. Partial. Cast. Overdent w/ Indepent Attach, Implant - Max + Mand Dent. Partial. Cast. Overdent w/ Indepent Attach, Implant - Max + Mand true false false 0 0 false 53924 16 M Dent/Cast/Indep/Imp/Alter Dent/Cast/Indep/Imp/Alter false false false 0 0 1919 0 MODBLIV false 53931 22 M Dent, Partial, Cast, Overdent, w/ Indepen Attach, Combin - Max Dent, Partial, Cast, Overdent, w/ Indepen Attach, Combin - Max true true false 0 3 0011 0 false 53932 22 M Dent, Partial, Cast, Overdent, w/ Indepen Attach, Combin - Mand Dent, Partial, Cast, Overdent, w/ Indepen Attach, Combin - Mand true true false 0 3 0022 0 false 53933 16 M Dent/Cast/Indep/Comb/Max& Dent/Cast/Indep/Comb/Max& false false false 0 0 1919 0 MODBLIV false 53934 16 M Dent/Cast/Indep/Comb/Alte Dent/Cast/Indep/Comb/Alte false false false 0 0 1919 0 MODBLIV false 53940 16 M Dent/Part/Cast,Over/Rent Dent/Part/Cast,Over/Rent false false false 0 0 1919 0 MODBLIV false 53941 16 M Dent, Partial, Cast, Overdent, w/ Retention - Max Dent, Partial, Cast, Overdent, w/ Retention - Max true false false 0 0 false 53942 16 M Dent, Partial, Cast, Overdent, w/ Retention - Mand Dent, Partial, Cast, Overdent, w/ Retention - Mand true false false 0 0 false 53943 16 M Denture,Partial,Cast,Overdent,W/Retention Supported by Natural Teeth - Max + Mand Denture,Partial,Cast,Overdent,W/Retention Supported by Natural Teeth - Max + Mand true false false 0 0 false 53944 16 M Dent/Cast/Reten/Nat/Alter Dent/Cast/Reten/Nat/Alter false false false 0 0 1919 0 MODBLIV false 53951 22 M Dent, Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Implant - Max Dent, Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Implant - Max true true false 0 3 0011 0 false 53952 22 M Dent, Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Implant - Mand Dent, Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Implant - Mand true true false 0 3 0022 0 false 53953 22 M Dent Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Implant - Max & Mand Dent, Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Implant - Max & Mand true true false 0 3 0102 0 false 53954 16 M Dent/Cast/Reten/Imp/Alter Dent/Cast/Reten/Imp/Alter false false false 0 0 1919 0 MODBLIV false 53961 22 M Dent, Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Combin - Max Dent, Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Combin - Max true true false 0 3 0011 0 false 53962 22 M Dent, Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Combin - Mand Dent, Partial, Cast, Overdent, w/ Retention ( Coping Crown ) Combin - Mand true true false 0 3 0022 0 false 53963 16 M Dent/Cast/Reten/Comb/Max& Dent/Cast/Reten/Comb/Max& false false false 0 0 1919 0 MODBLIV false 53964 16 M Dent/Cast/Reten/Comb/Alte Dent/Cast/Reten/Comb/Alte false false false 0 0 1919 0 MODBLIV false 54201 16 M Denture Adjust, Partial / Complete Denture, Minor - 1 Unit Denture Adjust, Partial / Complete Denture, Minor - 1 Unit true false false 0 0 false 54202 16 M Denture Adjust, Partial / Complete Denture, Minor - 2 Units Denture Adjust, Partial / Complete Denture, Minor - 2 Units true false false 0 0 false 54205 16 M Denture Adjustment Denture Adjustment false false false 0 0 1919 0 MODBLIV false 54209 16 M Denture Adjust, Partial / Complete Denture, Minor- over 2 Units Denture Adjust, Partial / Complete Denture, Minor- over 2 Units true false false 0 0 false 54220 16 M Part Mand Reset Part Mand Reset false false false 0 0 1919 0 MODBLIV false 54301 16 M Dent Adjust, Partial / Complete Dent, Remount & Equilibra - Max Dent Adjust, Partial / Complete Dent, Remount & Equilibra - Max true false false 0 0 false 54302 16 M Dent Adjust, Partial / Complete Dent, Remount & Equilibra - Mand Dent Adjust, Partial / Complete Dent, Remount & Equilibra - Mand true false false 0 0 false 54303 16 M Dentures,Partial,Acrylic, with Metal Wrought/Cast Clasps and/or Rests-Max +Mand Dentures,Partial,Acrylic, with Metal Wrought/Cast Clasps and/or Rests-Max +Mand true false false 0 0 false 54401 16 M Remount & Equilibration Remount & Equilibration false false false 0 0 1919 0 MODBLIV false 54402 16 M Remount & Equilibration Remount & Equilibration false false false 0 0 1919 0 MODBLIV false 54403 16 M Remount/Comp/Metal Max+Ma Remount/Comp/Metal Max+Ma false false false 0 0 1919 0 MODBLIV false 54501 16 M Remount & Equilibration Remount & Equilibration false false false 0 0 1919 0 MODBLIV false 54502 16 M Remount & Equilibration Remount & Equilibration false false false 0 0 1919 0 MODBLIV false 54503 16 M Remount/Part/Metal Max+Ma Remount/Part/Metal Max+Ma false false false 0 0 1919 0 MODBLIV false 55101 16 M Repair / Addition, Complete Dent - Max Dent, Repair / Addition, Complete Dent - Max true false false 0 0 false 55102 16 M ent, Repair / Addition, Complete Dent - Mand Repair / Addition, Complete Dent - Mand true false false 0 0 false 55103 16 M Repair / Addition, Partial Dent - Max Repair / Addition, Partial Dent - Max false false false 0 0 false 55104 16 M Repair / Addition, Partial Dent - Mand Repair / Addition, Partial Dent - Mand false false false 0 0 false 55105 16 M Replace Missing / Fractured Tooth on Partial / Complete Denture Replace Missing / Fractured Tooth on Partial / Complete Denture false false false 0 0 false 55106 16 M Replace Missing / Fractured Tooth on Partial / Complete Denture add Tooth Replace Missing / Fractured Tooth on Partial / Complete Denture add Tooth false false false 0 0 false 55201 16 M Repair Complete Denture, Impression Required - Max Repair Complete Denture, Impression Required - Max true false false 0 0 false 55202 16 M Repair Complete Denture, Impression Required - Mand Repair Complete Denture, Impression Required - Mand true false false 0 0 false 55203 16 M Fractured Partial (Maxillary) Fractured Partial (Maxillary) false false false 0 0 false 55204 16 M Fractured Partial (Mandibular) Fractured Partial (Mandibular) false false false 0 0 false 55301 16 M Repair / Addition, Partial Denture - Maxillary Repair / Addition, Partial Denture - Maxillary true false false 0 0 false 55302 16 M Repair / Addition, Partial Denture - Mandibular Repair / Addition, Partial Denture - Mandibular true false false 0 0 false 55401 16 M Repair / Addition, Partial Denture, Impression Required - Max Repair / Addition, Partial Denture, Impression Required - Max true false false 0 0 false 55402 16 M Repair / Addition, Partial Denture, Impression Required - Mand Repair / Addition, Partial Denture, Impression Required - Mand true false false 0 0 false 55403 16 M Rep/Part/Impress Max+Mand Rep/Part/Impress Max+Mand false false false 0 0 1919 0 MODBLIV false 55500 16 M Add Tooth to Max Partial Denture - 1 Unit Add Tooth to Max Partial Denture - 1 Unit false false false 0 0 false 55501 22 M Dentures, Implant Retained Prosthesis, Prophylaxis & Polish - 1Unit Dentures, Implant Retained Prosthesis, Prophylaxis & Polish - 1Unit true false false 0 0 false 55502 16 M Add Tooth to Max Patial Denture - Add Unit over 1 Add Tooth to Max Patial Denture - Add Unit over 1 false false false 0 0 false 55509 22 M Dentures, Implant Retained Prosthesis, Prophylaxis & Polish - Add Unit Dentures, Implant Retained Prosthesis, Prophylaxis & Polish - 1Unit true false false 0 0 false 55511 16 M Add Tooth to Mand Patial Denture - 1 Unit Add Tooth to Mand Patial Denture - 1 Unit false false false 0 0 false 55512 16 M Add Tooth to Mand Patial Denture - Add Unit Add Tooth to Mand Patial Denture - Add Unit false false false 0 0 false 55521 16 M Addition of Cast Clasp - Maxillary Addition of Cast Clasp - Maxillary false false false 0 0 false 55524 16 M Additional of Cast Clasp - Maxillary Additional of Cast Clasp - Maxillary false false false 0 0 false 55525 16 M Addition of Wrought Clasp - Maxillary Addition of Wrought Clasp - Maxillary false false false 0 0 false 55529 16 M Additional of Wrought Clasp - Maxillary Additional of Wrought Clasp - Maxillary false false false 0 0 false 55531 16 M Addition of Cast Clasp - Mandibular Addition of Cast Clasp - Mandibular false false false 0 0 false 55534 16 M Additional of Cast Clasp - Mandibular Additional of Cast Clasp - Mandibular false false false 0 0 false 55535 16 M Addition of Wrought Clasp - Mandibular Addition of Wrought Clasp - Mandibular false false false 0 0 false 55539 16 M Additional of Wrought Clasp - Mandibular Additional of Wrought Clasp - Mandibular false false false 0 0 false 55601 16 M Rebuilding, Worn Acrylic Denture Teeth - 1 Unit Rebuilding, Worn Acrylic Denture Teeth - 1 Unit false false false 0 0 false 55602 16 M Add Tooth to Max Partial Denture, Include Abutment - Add Unit over 1 Add Tooth to Max Partial Denture, Include Abutment - Add Unit over 1 false false false 0 0 false 55609 16 M Rebuilding, Worn Acrylic Denture Teeth - Add Unit Rebuilding, Worn Acrylic Denture Teeth - Add Unit false false false 0 0 false 55611 16 M Add Tooth to Mand Partial Denture, include Abutment - 1 Unit Add Tooth to Mand Partial Denture, include Abutment - 1 Unit false false false 0 0 false 55612 16 M Add Tooth to Mand Partial Denture, include Abutment - Add Unit over 1 Add Tooth to Mand Partial Denture, include Abutment - Add Unit over 1 false false false 0 0 false 55701 16 M Denture/Pigmented/One Uni Denture/Pigmented/One Uni false false false 0 0 1919 MODBLIV false 55709 16 M Denture/Pigmented/Each Ad Denture/Pigmented/Each Ad false false false 0 0 1919 MODBLIV false 56111 16 M Denture, Replication, Relining & Rebasing Provisional - Max Denture, Replication, Relining & Rebasing Provisional - Max true false false 0 0 false 56112 16 M Denture, Replication, Relining & Rebasing Provisional - Mand Denture, Replication, Relining & Rebasing Provisional - Mand true false false 0 0 false 56113 16 M Duplication/Comp Max+Mand Duplication/Comp Max+Mand false false false 0 0 1919 0 MODBLIV false 56121 16 M Duplication/Part Maxillar Duplication/Part Maxillar false false false 0 0 1919 0 MODBLIV false 56122 16 M Duplication/Part Mandibul Duplication/Part Mandibul false false false 0 0 1919 0 MODBLIV false 56123 16 M Duplication/Part Max+Mand Duplication/Part Max+Mand false false false 0 0 1919 0 MODBLIV false 56211 16 M Reline, Direct, Complete Denture - Maxillary Reline, Direct, Complete Denture - Maxillary false false false 0 0 false 56212 16 M Reline, Direct, Complete Denture - Mandibular Reline, Direct, Complete Denture - Mandibular false false false 0 0 false 56213 16 M Rel/Direct/Comp Max+Mand Rel/Direct/Comp Max+Mand false false false 0 0 1919 0 MODBLIV false 56221 16 M Reline, Direct, Partial Denture - Maxillary Reline, Direct, Partial Denture - Maxillary false false false 0 0 false 56222 16 M Reline, Direct, Partial Denture - Mandibular Reline, Direct, Partial Denture - Mandibular false false false 0 0 false 56223 16 M Rel/Direct/Part Max+Mand Rel/Direct/Part Max+Mand false false false 0 0 1919 0 MODBLIV false 56231 16 M Reline, Proccessed, Complete Denture -Maxillary Reline, Proccessed, Complete Denture - Maxillary true false false 0 0 false 56232 16 M Reline, Proccessed, Complete Denture - Mandibular Reline, Proccessed, Complete Denture - Mandibular true false false 0 0 false 56233 16 M Rel/Proc/Comp Max+Mand Rel/Proc/Comp Max+Mand false false false 0 0 1919 0 MODBLIV false 56241 16 M Reline, Processed, Partial Denture - Maxillary Reline, Processed, Partial Denture - Maxillary true false false 0 0 false 56242 16 M Reline, Processed, Partial Denture - Mandibular Reline, Processed, Partial Denture - Mandibular true false false 0 0 false 56243 16 M Rel/Proc/Part Max+Mand Rel/Proc/Part Max+Mand false false false 0 0 1919 0 MODBLIV false 56251 16 M Reline, Processed, Functional Impression, Complete Denture - Max Reline, Processed, Functional Impression, Complete Denture - Max true false false 0 0 false 56252 16 M Reline, Processed, Functional Impression, Complete Denture - Mand Reline, Processed, Functional Impression, Complete Denture - Mand true false false 0 0 false 56253 16 M Rel/Proc/Func/Comp Max+Ma Rel/Proc/Func/Comp Max+Ma false false false 0 0 1919 0 MODBLIV false 56261 16 M Reline, Processed, Functional Impression, Partial Denture - Max Reline, Processed, Functional Impression, Partial Denture - Max true false false 0 0 false 56262 16 M Reline, Processed, Functional Impression, Partial Denture - Mand Reline, Processed, Functional Impression, Partial Denture - Mand true false false 0 0 false 56263 16 M Rel/Proc/Func/Part Max+Ma Rel/Proc/Func/Part Max+Ma false false false 0 0 1919 0 MODBLIV false 56311 16 M Rebase, Complete Denture - Maxillary Rebase, Complete Denture - Maxillary true false false 0 0 false 56312 16 M Rebase, Complete Denture - Mandibular Rebase, Complete Denture - Mandibular true false false 0 0 false 56313 16 M Rebase/Comp Max+Mand Rebase/Comp Max+Mand false false false 0 0 1919 0 MODBLIV false 56321 16 M Rebase, Partial Denture - Maxillary Rebase, Partial Denture - Maxillary true false false 0 0 false 56322 16 M Rebase, Partial Denture - Mandibular Rebase, Partial Denture - Mandibular true false false 0 0 false 56323 16 M Rebase/Part Max+Mand Rebase/Part Max+Mand false false false 0 0 1919 0 MODBLIV false 56331 16 M Cud,Rebase,Process,Func.I Cud,Rebase,Process,Func.I false false false 0 0 1919 0 MODBLIV false 56332 16 M Cld,Rebase,Process,Func.I Cld,Rebase,Process,Func.I false false false 0 0 1919 0 MODBLIV false 56333 16 M Rebase/Comp/Func Max+Mand Rebase/Comp/Func Max+Mand false false false 0 0 1919 0 MODBLIV false 56341 16 M Rebase Partial Upper Dent Rebase Partial Upper Dent false false false 0 0 1919 0 MODBLIV false 56342 16 M Rebase Partial Lower Dent Rebase Partial Lower Dent false false false 0 0 1919 0 MODBLIV false 56343 16 M Rebase/Part/Func Max+Mand Rebase/Part/Func Max+Mand false false false 0 0 1919 0 MODBLIV false 56411 16 M Remake, Partial Denture ( Equilibration ) - Maxillary Remake, Partial Denture ( Equilibration ) - Maxillary true false false 0 0 false 56412 16 M Remake, Partial Denture ( Equilibration ) - Mandibular Remake, Partial Denture ( Equilibration ) - Mandibular true false false 0 0 false 56413 16 M Remake/Exist/Part Max+Man Remake/Exist/Part Max+Man false false false 0 0 1919 0 MODBLIV false 56511 16 M Denture,Therapeutic Tissue Condition, per Appt, Complete Denture - Max Denture, Therapeutic Tissue Condition, per Appt, Complete Denture - Max false false false 0 0 false 56512 16 M Denture, Therapeutic Tissue Condition, per Appt, Complete Denture - Mand Denture,Therapeutic Tissue Condition, per Appt, Complete Denture - Mand false false false 0 0 false 56513 16 M Tissue Con/Comp Max+Mand Tissue Con/Comp Max+Mand false false false 0 0 1919 0 MODBLIV false 56521 16 M Denture, Therapeutic Tissue Condition, per Appt, Partial Denture - Max Denture, Therapeutic Tissue Condition, per Appt, Partial Denture - Max false false false 0 0 false 56522 16 M Denture, Therapeutic Tissue Condition, per Appt, Partial Denture - Mand Denture, Therapeutic Tissue Condition, per Appt, Partial Denture - Mand false false false 0 0 false 56523 16 M Denture, Therapeutic Tissue Condition, per Appt, Partial Denture - Max + Mand Denture, Therapeutic Tissue Condition, per Appt, Partial Denture - Max + Mand false false false 0 0 false 56531 16 M Dent/Tiss, Cond/Nat/Max Dent/Tiss, Cond/Nat/Max false false false 0 0 1919 0 MODBLIV false 56532 16 M Dent/Tiss, Cond/Nat/Mand Dent/Tiss, Cond/Nat/Mand false false false 0 0 1919 0 MODBLIV false 56533 16 M Dent/Tiss, Cond/Nat/Max&m Dent/Tiss, Cond/Nat/Max&m false false false 0 0 1919 0 MODBLIV false 56541 22 M Dent, Tissue Condition, per Appt, Complete Overdent, Implant - Max Dent, Tissue Condition, per Appt, Complete Overdent, Implant - Max false true false 0 3 0011 0 false 56542 22 M Dent, Tissue Condition, per Appt, Complete Overdent, Implant - Mand Dent, Tissue Condition, per Appt, Complete Overdent, Implant - Mand false true false 0 3 0022 0 false 56543 16 M Dent/Tiss,Cond/Imp/Max&ma Dent/Tiss,Cond/Imp/Max&ma false false false 0 0 1919 0 MODBLIV false 56551 16 M Dent/Cond/Part/Nat/Max Dent/Cond/Part/Nat/Max false false false 0 0 1919 0 MODBLIV false 56552 16 M Dent/Cond/Part/Nat/Mand Dent/Cond/Part/Nat/Mand false false false 0 0 1919 0 MODBLIV false 56553 16 M Dent/Cond/Part/Nat/Max&ma Dent/Cond/Part/Nat/Max&ma false false false 0 0 1919 0 MODBLIV false 56561 22 M Dent, Tissue Condition, per Appt, Partial Overdent, Implant - Max Dent, Tissue Condition, per Appt, Partial Overdent, Implant - Max false true false 0 3 0011 0 false 56562 22 M Dent, Tissue Condition, per Appt, Partial Overdent, Implant - Mand Dent, Tissue Condition, per Appt, Partial Overdent, Implant - Mand false true false 0 3 0022 0 false 56563 16 M Dent/Cond/Part/Imp.Max&ma Dent/Cond/Part/Imp.Max&ma false false false 0 0 1919 0 MODBLIV false 56601 16 M Denture, Resilient Liner, in Relined / Rebased Denture Denture, Resilient Liner, in Relined / Rebased Denture true false false 0 0 false 56602 16 M Denture, Resetting of Teeth Denture, Resetting of Teeth true false false 0 0 false 56603 16 M Cast Occlusal Surface ( Remount and Equilibration) Cast Occlusal Surface ( Remount and Equilibration) true false false 0 0 false 56604 16 M Amalgam Centric-Hlding Amalgam Centric-Hlding false false false 0 0 1919 MODBLIV false 56611 16 M Attach/Remov,Prosth,Dir 1 Attach/Remov,Prosth,Dir 1 false false false 0 0 1919 0 MODBLIV false 56612 16 M Attach/Remov,Prosth,Dir 2 Attach/Remov,Prosth,Dir 2 false false false 0 0 1919 0 MODBLIV false 56619 16 M Attach/Remov,Prosth,Dir A Attach/Remov,Prosth,Dir A false false false 0 0 1919 0 MODBLIV false 56621 16 M Attach/Remov,Prosth,Indir Attach/Remov,Prosth,Indir false false false 0 0 1919 0 MODBLIV false 57101 16 M Prost/Facial Orbital Prost/Facial Orbital false false false 0 0 1919 0 MODBLIV false 57102 16 M Prost/Facial Nose Prost/Facial Nose false false false 0 0 1919 0 MODBLIV false 57103 16 M Prost/Facial Ear Prost/Facial Ear false false false 0 0 1919 0 MODBLIV false 57104 16 M Prost/Facial Patch Prost/Facial Patch false false false 0 0 1919 0 MODBLIV false 57105 16 M Prost/Facial Complex Prost/Facial Complex false false false 0 0 1919 0 MODBLIV false 57106 16 M Prost/Facial/Moulage Comp Prost/Facial/Moulage Comp false false false 0 0 1919 0 MODBLIV false 57107 16 M Prost/Facial/Moulage Sect Prost/Facial/Moulage Sect false false false 0 0 1919 0 MODBLIV false 57108 16 M Prost/Facial/Ocular/Confo Prost/Facial/Ocular/Confo false false false 0 0 1919 0 MODBLIV false 57109 16 M Prost/Facial/Ocular/Prost Prost/Facial/Ocular/Prost false false false 0 0 1919 0 MODBLIV false 57133 16 M false false false 0 0 1919 0 MODBLIV false 57201 16 M Prost/Obtur Cleft Palate Prost/Obtur Cleft Palate false false false 0 0 1919 0 MODBLIV false 57202 16 M Prost/Obtur Palatal Prost/Obtur Palatal false false false 0 0 1919 0 MODBLIV false 57203 16 M Prost/Obtur Post-Maxillec Prost/Obtur Post-Maxillec false false false 0 0 1919 0 MODBLIV false 57204 16 M Prost/Obtur Temp Palatal Prost/Obtur Temp Palatal false false false 0 0 1919 0 MODBLIV false 57205 16 M Prost/Obtur Resilient Prost/Obtur Resilient false false false 0 0 1919 0 MODBLIV false 57206 16 M Prost/Obtur Hollow Bulb Prost/Obtur Hollow Bulb false false false 0 0 1919 0 MODBLIV false 57207 16 M Prost/Obtur Inflatable Prost/Obtur Inflatable false false false 0 0 1919 0 MODBLIV false 57208 16 M Prost/Obtur Modifiaction Prost/Obtur Modifiaction false false false 0 0 1919 0 MODBLIV false 57209 16 M Prost/Speech Aid Prost/Speech Aid false false false 0 0 1919 0 MODBLIV false 57301 16 M Prost/Velar Bulb Prost/Velar Bulb false false false 0 0 1919 0 MODBLIV false 57302 16 M Prost/Velar Lift Button Prost/Velar Lift Button false false false 0 0 1919 0 MODBLIV false 57303 16 M Prost/Retention Spiral Sp Prost/Retention Spiral Sp false false false 0 0 1919 0 MODBLIV false 57304 16 M Prothesis, Maxillofacial, Prothesis, Maxillofacial, false false false 0 0 1919 0 MODBLIV false 57305 16 M Prost/Guide Plane/Condyla Prost/Guide Plane/Condyla false false false 0 0 1919 0 MODBLIV false 57306 16 M Prost/Implant/Silastic Ch Prost/Implant/Silastic Ch false false false 0 0 1919 0 MODBLIV false 57307 16 M Prost/Mesh Prosthesis Prost/Mesh Prosthesis false false false 0 0 1919 0 MODBLIV false 57308 16 M Prost/Skull Plate/Custom Prost/Skull Plate/Custom false false false 0 0 1919 0 MODBLIV false 57309 16 M Prost/Akerman Prost/Akerman false false false 0 0 1919 0 MODBLIV false 57311 16 M Prost/Feeding Appliance Prost/Feeding Appliance false false false 0 0 1919 0 MODBLIV false 57321 16 M Prost/Lingual Prosthesis Prost/Lingual Prosthesis false false false 0 0 1919 0 MODBLIV false 57341 16 M Prost/Mandib/With Guide Prost/Mandib/With Guide false false false 0 0 1919 0 MODBLIV false 57342 16 M Prost/Mandib/Without Guid Prost/Mandib/Without Guid false false false 0 0 1919 0 MODBLIV false 57351 16 M Prost/Maxillofacial/Fixed Prost/Maxillofacial/Fixed false false false 0 0 1919 0 MODBLIV false 57361 16 M Prost/Palatal Augmentatio Prost/Palatal Augmentatio false false false 0 0 1919 0 MODBLIV false 57371 16 M Prost/Palatal Lift Prost/Palatal Lift false false false 0 0 1919 0 MODBLIV false 57372 16 M Gingival Prothesis Gingival Prothesis false false false 0 0 false 57401 16 M Prosthesis, Tmj, Exercise Prosthesis, Tmj, Exercise false false false 0 0 1919 0 MODBLIV false 57402 16 M Prosthesis, Tmj, Splint, Prosthesis, Tmj, Splint, false false false 0 0 1919 0 MODBLIV false 57501 16 M Prost/Splint/Stout Prost/Splint/Stout false false false 0 0 1919 0 MODBLIV false 57502 16 M Prost/Splint/Cast Capped Prost/Splint/Cast Capped false false false 0 0 1919 0 MODBLIV false 57503 16 M Prost/Splint/Gunning Prost/Splint/Gunning false false false 0 0 1919 0 MODBLIV false 57504 16 M Prost/Splint/Bar Splint Prost/Splint/Bar Splint false false false 0 0 1919 0 MODBLIV false 57505 16 M Prost/Splint/Scaffolding Prost/Splint/Scaffolding false false false 0 0 1919 0 MODBLIV false 57506 16 M Prost/Splint/Cast Adjusta Prost/Splint/Cast Adjusta false false false 0 0 1919 0 MODBLIV false 57507 16 M Prost/Splint/Template/Sur Prost/Splint/Template/Sur false false false 0 0 1919 0 MODBLIV false 57508 16 M Prost/Splint/Commisure Prost/Splint/Commisure false false false 0 0 1919 0 MODBLIV false 57601 16 M Ridge Extension Ridge Extension false false false 0 0 1919 0 MODBLIV false 57602 16 M Palatal Palatal false false false 0 0 1919 0 MODBLIV false 57603 16 M Skin Grafts Skin Grafts false false false 0 0 1919 0 MODBLIV false 57604 16 M Mucous Membrane Grafts Mucous Membrane Grafts false false false 0 0 1919 0 MODBLIV false 57651 16 M Prost/Radi/Vehicle Carrie Prost/Radi/Vehicle Carrie false false false 0 0 1919 0 MODBLIV false 57652 16 M Prost/Radi/Shield/Extra Prost/Radi/Shield/Extra false false false 0 0 1919 0 MODBLIV false 57653 16 M Prost/Radi/Shield/Intra Prost/Radi/Shield/Intra false false false 0 0 1919 0 MODBLIV false 57654 16 M Prost/Radi/Cone Locator Prost/Radi/Cone Locator false false false 0 0 1919 0 MODBLIV false 57655 16 M Prost/Radi,Guide/W/Radima Prost/Radi,Guide/W/Radima false false false 0 0 1919 0 MODBLIV false 57660 16 M Prosthesis, Stents, Decom Prosthesis, Stents, Decom false false false 0 0 1919 0 MODBLIV false 57661 16 M Prost/Decomp Stent/Local Prost/Decomp Stent/Local false false false 0 0 1919 0 MODBLIV false 57662 16 M Prost/Decomp Stent Prost/Decomp Stent false false false 0 0 1919 0 MODBLIV false 57701 16 M Prost/Ortho/Extraoral Prost/Ortho/Extraoral false false false 0 0 1919 0 MODBLIV false 57702 16 M Prost/Ortho/Intraoral Prost/Ortho/Intraoral false false false 0 0 1919 0 MODBLIV false 58111 16 M denture, Complete, Tissue Borne W/ Attach - Max denture, Complete, Tissue Borne W/ Attach - Max true false false 0 0 false 58112 16 M denture, Complete, Tissue Borne W/ Attach - Mand denture, Complete, Tissue Borne W/ Attach - Mand true false false 0 0 false 58113 16 M denture, Complete, Tissue Borne W/ Attach - Max + Mand denture, Complete, Tissue Borne W/ Attach - Max + Mand true false false 0 0 false 58121 16 M Denture, Removable W/ Bar - Max Denture, Removable W/ Bar - Max true false false 0 0 false 58122 16 M Denture, Removable W/ Bar - Mand Denture, Removable W/ Bar - Mand true false false 0 0 false 58123 16 M Denture, Removable W/ Bar - Max + Mand Denture, Removable W/ Bar - Max + Mand true false false 0 0 false 58211 16 M Free End, Cast Frame / Connector, Clasps & Rest - Max Free End, Cast Frame / Connector, Clasps & Rest - Max true false false 0 0 false 58212 16 M Free End, Cast Frame / Connector, Clasps & Rest - Mand Free End, Cast Frame / Connector, Clasps & Rest - Mand true false false 0 0 false 58213 16 M Free End, Cast Frame / Connector, Clasps & Rest - Max - mand Free End, Cast Frame / Connector, Clasps & Rest - Max - mand true false false 0 0 false 58221 16 M Tooth Borne, Cast / Frame Connector, Clasps & Rest - Max Tooth Borne, Cast / Frame Connector, Clasps & Rest - Max true false false 0 0 false 58222 16 M Tooth Borne, Cast / Frame Connector, Clasps & Rest - Mand Tooth Borne, Cast / Frame Connector, Clasps & Rest - Mand true false false 0 0 false 58223 16 M Tooth Borne, Cast / Frame Connector, Clasps & Rest - Max + Mand Tooth Borne, Cast / Frame Connector, Clasps & Rest - Max + Mand true false false 0 0 false 58311 16 M Acrylic, Resilient Retainer - Max Acrylic, Resilient Retainer - Max true false false 0 0 false 58312 16 M Acrylic, Resilient Retainer - Mand Acrylic, Resilient Retainer - Mand true false false 0 0 false 58313 16 M Acrylic, Resilient Retainer - Max + Mand Acrylic, Resilient Retainer - Max + Mand true false false 0 0 false 58321 16 M Acrylic, with Metal Wrought - Max Acrylic, with Metal Wrought - Max true false false 0 0 false 58322 16 M Acrylic, with Metal Wrought - Mand Acrylic, with Metal Wrought - Mand true false false 0 0 58323 16 M Acrylic, with Metal Wrought - Max + Mand Acrylic, with Metal Wrought - Max + Mand true false false 0 0 58331 16 M Acrylic with Metal Wrought Palatal - Max Acrylic with Metal Wrought Palatal - Max true false false 0 0 58332 16 M Acrylic with Metal Wrought Palatal - Mand Acrylic with Metal Wrought Palatal - Mand true false false 0 0 58333 16 M Acrylic with Metal Wrought Palatal - Max + Mand Acrylic with Metal Wrought Palatal - Max + Mand true false false 0 0 58341 16 M Overdenture, Actylic with Metal Case - Max Overdenture, Actylic with Metal Case - Max true false false 0 0 58342 16 M Overdenture, Actylic with Metal Case - Mand Overdenture, Actylic with Metal Case - Mand true false false 0 0 58343 16 M Overdenture, Actylic with Metal Case - Max + Mand Overdenture, Actylic with Metal Case - Max + Mand true false false 0 0 58411 22 M Exam & Diagno, Prosthodontic, Endentulous Exam & Diagno, Prosthodontic, Endentulous false false false 0 0 false 58511 16 M Dentures, Partial, Free End, Cast Frame, Max Dentures, Partial, Free End, Cast Frame, Max true false false 0 0 58512 16 M Dentures, Partial, Free End, Cast Frame, Mand Dentures, Partial, Free End, Cast Frame, Mand true false false 0 0 58513 16 M Dentures, Partial, Free End, Cast Frame, Max + Mand Dentures, Partial, Free End, Cast Frame, Max + Mand true false false 0 0 58521 16 M Dentures, Partial, Tooth Borne, Cast Frame, Max Dentures, Partial, Tooth Borne, Cast Frame, Max true false false 0 0 58522 16 M Dentures, Partial, Tooth Borne, Cast Frame, Mand Dentures, Partial, Tooth Borne, Cast Frame, Mand true false false 0 0 58523 16 M Dentures, Partial, Tooth Borne, Cast Frame, Max + Mand Dentures, Partial, Tooth Borne, Cast Frame, Max + Mand true false false 0 0 58611 16 M Dentures, Partial, Resilient Retainer, Max Dentures, Partial, Resilient Retainer, Max true false false 0 0 false 58612 16 M Dentures, Partial, Resilient Retainer, Mand Dentures, Partial, Resilient Retainer, Mand true false false 0 0 58613 16 M Dentures, Partial, Resilient Retainer, Max + Mand Dentures, Partial, Resilient Retainer, Max + Mand true false false 0 0 58621 16 M Dentures, Partial with Metal Wrought, Max Dentures, Partial with Metal Wrought, Max true false false 0 0 58622 16 M Dentures, Partial with Metal Wrought, Mand Dentures, Partial with Metal Wrought, Mand true false false 0 0 58623 16 M Dentures, Partial with Metal Wrought, Max + Mand Dentures, Partial with Metal Wrought, Max + Mand true false false 0 0 58631 16 M Dentures, Partial with Metal Cast, Max Dentures, Partial with Metal Cast, Max true false false 0 0 58632 16 M Dentures, Partial with Metal Cast, Mand Dentures, Partial with Metal Cast, Mand true false false 0 0 false 58633 16 M Dentures, Partial with Metal Cast, Max + Mand Dentures, Partial with Metal Cast, Max + Mand true false false 0 0 58641 16 M Overdentures, Partial with Metal Cast, Max Overdentures, Partial with Metal Cast, Max true false false 0 0 58642 16 M Overdentures, Partial with Metal Cast, Mand Overdentures, Partial with Metal Cast, Mand true false false 0 0 58643 16 M Overdentures, Partial with Metal Cast, Max + Mand Overdentures, Partial with Metal Cast, Max + Mand true false false 0 0 58901 16 M Exam and Diag, Prosthetic Exam and Diag, Prosthetic false false false 0 0 59025 16 M Tray Tray false false false 0 0 false 0 59076 16 M Upper Partial (includes first tooth) Upper Partial (includes first tooth) false false false 0 0 false 0 59077 16 M Lower Partial (includes first tooth) false false false 0 0 false 0 59097 16 M Bite Block Reline, Processed (includes model) Bite Block Reline, Processed (includes model) false false false 0 0 false 0 59105 16 M Model Model false false false 0 0 false 0 59111 16 M Dentures, Partial, Acrylic - Resilient Retainer Maxillary Dentures, Partial, Acrylic - Resilient Retainer Maxillary true false false 0 0 false 59112 16 M Dentures, Partial, Acrylic - Resilient Retainer Mandibular Dentures, Partial, Acrylic - Resilient Retainer Mandibular true false false 0 0 false 59121 16 M Denture, Partial, Acrylic, Resilient Retainer ( Immed ) - Max Denture, Partial, Acrylic, Resilient Retainer ( Immed ) - Max true false false 0 0 false 59122 16 M Denture, Partial, Acrylic, Resilient Retainer ( Immed ) - Mand Denture, Partial, Acrylic, Resilient Retainer ( Immed ) - Mand true false false 0 0 false 59134 16 M Upper Upper false false false 0 0 false 0 59135 16 M Lower Lower false false false 0 0 false 0 59201 16 M Acrylic, w/ Metal Clasp - Max Acrylic, w/ Metal Clasp - Max true false false 0 0 false 59202 16 M Acrylic, w/ Metal Clasp - Mand Acrylic, w/ Metal Clasp - Mand true false false 0 0 false 59211 16 M Partial, Denture, w/ Metal Wrought ( Immed ) - Max Partial, Denture, w/ Metal Wrought ( Immed ) - Max true false false 0 0 false 59212 16 M Partial, Denture, w/ Metal Wrought ( Immed ) - Mand Partial, Denture, w/ Metal Wrought ( Immed ) - Mand true false false 0 0 false 59301 16 M Partial Dentures, Acrylic, w/ Bar - Max Partial Dentures, Acrylic, w/ Bar - Max true false false 0 0 false 59302 16 M Partial Dentures, Acrylic, w/ Bar - Mand Partial Dentures, Acrylic, w/ Bar - Mand true false false 0 0 false 59311 16 M Denture, Partial, Acrylic w/ Bar & Clasp ( Immed ) - Max Denture, Partial, Acrylic w/ Bar & Clasp ( Immed ) - Max true false false 0 0 false 59312 16 M Denture, Partial, Acrylic w/ Bar & Clasp ( Immed ) - Mand Denture, Partial, Acrylic w/ Bar & Clasp ( Immed ) - Mand true false false 0 0 false 59511 16 M Denture Partial, Cast w/ Acrylic Base, Free End - Max Denture Partial, Cast w/ Acrylic Base, Free End - Max true false false 0 0 false 59512 16 M Denture Partial, Cast w/ Acrylic Base, Free End - Mand Denture Partial, Cast w/ Acrylic Base, Free End - Mand true false false 0 0 false 59521 16 M Denture Partial, Cast w/ Acrylic Base, Free End ( Immed ) - Max Denture Partial, Cast w/ Acrylic Base, Free End ( Immed ) - Max true false false 0 0 false 59522 16 M Denture Partial, Cast w/ Acrylic Base, Free End ( Immed ) - Mand Denture Partial, Cast w/ Acrylic Base, Free End ( Immed ) - Mand true false false 0 0 false 59531 16 M Denture Partial, Tooth Borne - Max Denture Partial, Tooth Borne - Max true false false 0 0 false 59532 16 M Denture Partial, Tooth Borne - Mand Denture Partial, Tooth Borne - Mand true false false 0 0 false 59541 16 M Denture, Partial, Tooth Borne ( Immed ) - Max Denture, Partial, Tooth Borne ( Immed ) - Max true false false 0 0 false 59542 16 M Denture, Partial, Tooth Borne ( Immed ) - Mamd Denture, Partial, Tooth Borne ( Immed ) - Mand true false false 0 0 false 59601 16 M Exam & Diagnosis - Prosthetic by Dentist Exam & Diagnosis - Prosthetic by Dentist. false false false 0 0 false 59702 16 B Each additional tooth Each additional tooth false false false 0 0 false 0 61100 17 M Theraputic Apical Closure Theraputic Apical Closure false false false 0 0 1919 MODBLIV false 61200 17 M Vital Pulpotomy,Permanent Vital Pulpotomy,Permanent false false false 0 0 1919 MODBLIV false 61300 17 M Vital Pulpotomy,Primary Vital Pulpotomy,Primary false false false 0 0 1919 MODBLIV false 62100 17 M Rt Canal Therapy Perm / 1 Rt Canal Therapy Perm / 1 false false false 0 0 1919 MODBLIV false 62101 17 M Pontics , Metal Pontics , Metal true true false 0 0 1418 0 false 62102 17 M Pontics, Metal Framework Pontics, Metal Framework true true false 0 0 1418 0 false 62103 17 M Pontic, Prefabricated Attach Facing Pontic, Prefabricated Attach Facing true false false 0 0 false 62104 17 M Pontics, ,Attach to Retainer Pontics, ,Attach to Retainer true false false 0 0 false 62105 22 M Pontics, Attach to Implant Pontics, Attach to Implant true false false 0 0 false 62107 17 M Pontics/Semi Prec Rest Ad Pontics/Semi Prec Rest Ad false false false 0 0 1919 0 MODBLIV false 62108 17 M Pontics/Semi Prec/Attach Pontics/Semi Prec/Attach false false false 0 0 1919 0 MODBLIV false 62200 17 M Rt Canal Therapy Perm / 2 Rt Canal Therapy Perm / 2 false false false 0 0 1919 MODBLIV false 62300 17 M Rt Canal Therapy Perm / 3 Rt Canal Therapy Perm / 3 false false false 0 0 1919 MODBLIV false 62310 17 M Comp Max On Imp Comp Max On Imp false false false 0 0 1919 0 MODBLIV false 62400 17 M Rt Canal Therapy Perm / 4 Rt Canal Therapy Perm / 4 false false false 0 0 1919 MODBLIV false 62500 17 M Rt Canal Therapy Perm / 5 Rt Canal Therapy Perm / 5 false false false 0 0 1919 MODBLIV false 62501 17 M Pontics, Fused to metal Pontics, Fused to metal true true false 0 0 1418 0 false 62502 17 M Pontics, Aluminous Pontics, Aluminous true true false 0 0 1418 0 false 62507 17 M Pontics Semi Prec Rest Pontics Semi Prec Rest false false false 0 0 1919 0 MODBLIV false 62508 17 M Pontics Semi Prec Attach Pontics Semi Prec Attach false false false 0 0 1919 0 MODBLIV false 62600 17 M Rt Canal Therapy Prim / 1 Rt Canal Therapy Prim / 1 false false false 0 0 1919 MODBLIV false 62700 17 M Rt Canal Therapy Prim / 2 Rt Canal Therapy Prim / 2 false false false 0 0 1919 MODBLIV false 62701 17 M Pontics, Processed to Metal Pontics, Processed to Metal true true false 0 0 1418 0 false 62702 17 M Pontics, Indirect ( provisional ) Pontics, Indirect ( provisional ) true true false 0 0 1418 0 false 62703 17 M Pontics, Bonded to Adjacent, Direct ( Provisional ) Pontics, Bonded to Adjacent, Direct (Provisional ) true true false 0 0 1418 0 false 62704 15 M Pontics: Acrylic/Composite/Compomer true false false 0 0 false 0 62707 17 M Pontics/Acry/Semi Or Prec Pontics/Acry/Semi Or Prec false false false 0 0 1919 0 MODBLIV false 62708 17 M Ponticsacry/Semi-Prec/Att Ponticsacry/Semi-Prec/Att false false false 0 0 1919 0 MODBLIV false 62800 17 M Rt Canal Therapy Prim / 3 Rt Canal Therapy Prim / 3 false false false 0 0 1919 MODBLIV false 62801 17 M Natural Crown Bonded to Adjacent Natural Crown Bonded to Adjacent false true false 0 0 1418 0 false 62802 17 M Natural Crown Bonded to Adjacent - Long Term Natural Crown Bonded to Adjacent - Long Term false false false 0 0 false 63001 17 M Recontour Retainer/Pontics, per tooch-1Unit of Time Recontour Retainer / Pontics, per tooth - 1Unit true true false 0 0 1418 0 false 63009 17 M Recontour Retainer / Pontic, per tooth - Add Unit Recontour Retainer / Pontic, per tooth - Add Unit false true false 0 0 1418 0 false 63100 17 M Apicoectomy/Ant/Separate Apicoectomy/Ant/Separate false false false 0 0 1919 MODBLIV false 63200 17 M Apicoectomy/Ant/Endo,Man. Apicoectomy/Ant/Endo,Man. false false false 0 0 1919 MODBLIV false 63300 17 M Retrofilling Anterior Retrofilling Anterior false false false 0 0 1919 MODBLIV false 63800 17 M Apicoectomy/Post/Separate Apicoectomy/Post/Separate false false false 0 0 1919 MODBLIV false 63900 17 M Apicoectomy/Post/Endo,Man Apicoectomy/Post/Endo,Man false false false 0 0 1919 MODBLIV false 64000 17 M Bleaching/Non Vital Initl Bleaching/Non Vital Initl false false false 0 0 1919 MODBLIV false 64100 17 M Bleaching/Non Vital/ Add. Bleaching/Non Vital/ Add. false false false 0 0 1919 MODBLIV false 64101 17 M Master Cast/Hinge Bow Master Cast/Hinge Bow false false false 0 0 1919 0 MODBLIV false 64102 17 M Master Cast/Gnathological Master Cast/Gnathological false false false 0 0 1919 0 MODBLIV false 64110 17 M Mast/Tech/Arb Term/Reg&tr Mast/Tech/Arb Term/Reg&tr false false false 0 0 1919 0 MODBLIV false 64111 17 M Master Cast/Arbit,Term 1u Master Cast/Arbit,Term 1u false false false 0 0 1919 0 MODBLIV false 64119 17 M Master Cast/Arbit,Term Ad Master Cast/Arbit,Term Ad false false false 0 0 1919 0 MODBLIV false 64120 17 M Mast/Tech/Arb/Term/True H Mast/Tech/Arb/Term/True H false false false 0 0 1919 0 MODBLIV false 64121 17 M Master Cast/True Hinge/1u Master Cast/True Hinge/1u false false false 0 0 1919 0 MODBLIV false 64129 17 M Master Cast/True Hinge/Ad Master Cast/True Hinge/Ad false false false 0 0 1919 0 MODBLIV false 64130 17 M Mast/Centric/Reg/Recordin Mast/Centric/Reg/Recordin false false false 0 0 1919 0 MODBLIV false 64131 17 M Master Cast/Centric/ 1 Un Master Cast/Centric/ 1 Un false false false 0 0 1919 0 MODBLIV false 64139 17 M Master Cast/Centric/ Add Master Cast/Centric/ Add false false false 0 0 1919 0 MODBLIV false 64140 17 M Mast/3d Record Of Mandibu Mast/3d Record Of Mandibu false false false 0 0 1919 0 MODBLIV false 64141 17 M Master Cast/3 Dim/ 1 Unit Master Cast/3 Dim/ 1 Unit false false false 0 0 1919 0 MODBLIV false 64149 17 M Master Cast/3 Dim/ Add Master Cast/3 Dim/ Add false false false 0 0 1919 0 MODBLIV false 64201 17 M Master Cast/Split 1 Unit Master Cast/Split 1 Unit false false false 0 0 1919 0 MODBLIV false 64202 17 M Master Cast/Split 2 Units Master Cast/Split 2 Units false false false 0 0 1919 0 MODBLIV false 64203 17 M Master Cast/Split 3 Units Master Cast/Split 3 Units false false false 0 0 1919 0 MODBLIV false 64204 17 M Master Cast/Split 4 Units Master Cast/Split 4 Units false false false 0 0 1919 0 MODBLIV false 64209 17 M Master Cast/Split Add Master Cast/Split Add false false false 0 0 1919 0 MODBLIV false 64210 17 M Master Cast/Mount/Facebow Master Cast/Mount/Facebow false false false 0 0 1919 0 MODBLIV false 64211 17 M Master Cast/W/O Face/ 1un Master Cast/W/O Face/ 1un false false false 0 0 1919 0 MODBLIV false 64219 17 M Master Cast/W/O Face/ Add Master Cast/W/O Face/ Add false false false 0 0 1919 0 MODBLIV false 64220 17 M Master Cast/Mount/Arb, Tr Master Cast/Mount/Arb, Tr false false false 0 0 1919 0 MODBLIV false 64221 17 M Master Cast/Arbit Fb/ 1un Master Cast/Arbit Fb/ 1un false false false 0 0 1919 0 MODBLIV false 64229 17 M Master Cast/Arbit Fb/ Add Master Cast/Arbit Fb/ Add false false false 0 0 1919 0 MODBLIV false 64230 17 M Master Cast/Mount,Kinemat Master Cast/Mount,Kinemat false false false 0 0 1919 0 MODBLIV false 64231 17 M Master Cast/Kinema/Fb/1 U Master Cast/Kinema/Fb/1 U false false false 0 0 1919 0 MODBLIV false 64239 17 M Master Cast/Kinema/Fb/Add Master Cast/Kinema/Fb/Add false false false 0 0 1919 0 MODBLIV false 64300 17 M Master Cast/Gnathological Master Cast/Gnathological false false false 0 0 1919 0 MODBLIV false 64301 17 M Mas,Cast Mount/Kinema/Tra Mas,Cast Mount/Kinema/Tra false false false 0 0 1919 0 MODBLIV false 64309 17 M Mas,Cast Mount/Kinema/Add Mas,Cast Mount/Kinema/Add false false false 0 0 1919 0 MODBLIV false 64401 17 M Master Cast Gnathological Master Cast Gnathological false false false 0 0 1919 0 MODBLIV false 64600 17 M Emergency Procedures Emergency Procedures false false false 0 0 1919 MODBLIV false 64700 17 M Mummification Of The Pulp Mummification Of The Pulp false false false 0 0 1919 MODBLIV false 64800 17 M Pulpectomy/One Canal/Emer Pulpectomy/One Canal/Emer false false false 0 0 1919 MODBLIV false 64900 17 M Re-Implant/Luxated Tooth Re-Implant/Luxated Tooth false false false 0 0 1919 MODBLIV false 65000 17 M Reposition/Tram/Displace Reposition/Tram/Displace false false false 0 0 1919 MODBLIV false 66111 17 M Replacement, removal, recementation Replacement, removal, recementation true true true 0 0 false 66112 17 M Replacement, removal, recementation Replacement, removal, recementation true true true 0 0 false 66113 17 M Replacement, removal, recementation Replacement, removal, recementation true true true 0 0 false 66114 17 M Replace Broken Prefabrica Replace Broken Prefabrica false false false 0 0 1919 0 MODBLIV false 66119 17 M Replace Broken Prefabrica Replace Broken Prefabrica false false false 0 0 1919 0 MODBLIV false 66211 17 M Repairs, Removal, Fixed Bridge / Prothesis - 1 Unit Repairs, Removal, Fixed Bridge / Prothesis - 1 Unit false false false 0 0 false 66212 17 M Repairs, Removal, Fixed Bridge / Prothesis - 2 Units Repairs, Removal, Fixed Bridge / Prothesis - 2 Units false true false 0 0 1919 0 false 66213 17 M Repairs, Removal, Fixed Bridge / Prothesis - 3 Units Repairs, Removal, Fixed Bridge / Prothesis - 3 Units false false false 0 0 false 66214 17 M Repairs, Removal, Fixed Bridge / Prothesis - 4 Units Repairs, Removal, Fixed Bridge / Prothesis - 4 Units false false false 0 0 false 66219 17 M Repairs, Removal, Fixed Bridge / Prothesis - Add Unit over 4 Repairs, Removal, Fixed Bridge / Prothesis - Add Unit over 4 false false false 0 0 false 66221 17 M Removel, FIxed Bridge ( New Prothesis ) - 1 Unit Removel, FIxed Bridge ( New Prothesis ) - 1 Unit false false false 0 0 false 66222 17 M Removel, FIxed Bridge ( New Prothesis ) - 2 Units Removel, FIxed Bridge ( New Prothesis ) - 2 Units false false false 0 0 false 66223 17 M Removel, FIxed Bridge ( New Prothesis ) - 3 Units Removel, FIxed Bridge ( New Prothesis ) - 3 Units false false false 0 0 false 66224 17 M Removel, FIxed Bridge ( New Prothesis ) - 4 Units Removel, FIxed Bridge ( New Prothesis ) - 4 Units false false false 0 0 false 66229 17 M Removel, FIxed Bridge ( New Prothesis ) - Add Unit over 4 Removel, FIxed Bridge ( New Prothesis ) - Add Unit over 4 false false false 0 0 false 66231 22 M Removal of Fixed Bridge, Implant - 1 Unit Removal of Fixed Bridge, Implant - 1 Unit false false false 0 0 false 66232 22 M Removal of Fixed Bridge, Implant - 2 Units Removal of Fixed Bridge, Implant - 2 Units false false false 0 0 false 66233 22 M Removal of Fixed Bridge, Implant - 3 Units Removal of Fixed Bridge, Implant - 3 Units false false false 0 0 false 66234 22 M Removal of Fixed Bridge Implant - 4 Units Removal of Fixed Bridge, Implant - 4 Units false false false 0 0 false 66239 22 M Removal of Fixed Bridge, Implant - Add Unit over 4 Removal of Fixed Bridge Implant - Add Unit over 4 false false false 0 0 false 66241 22 M Removal, Fixed Bridge, Implant ( New Prosthesis ) - 1 Unit Removal, Fixed Bridge, Implant ( New Prosthesis ) - 1 Unit false false false 0 0 false 66242 22 M Removal, Fixed Bridge, Implant ( New Prosthesis) - 2 Units Removal, Fixed Bridge, Implant ( New Prosthesis) - 2 Units false false false 0 0 false 66243 22 M Removal, Fixed Bridge, Implant ( New Prosthesis) - 3 Units Removal, Fixed Bridge, Implant ( New Prosthesis) - 3 Units false false false 0 0 false 66244 22 M Removal, Fixed Bridge, Implant ( New Prosthesis) - 4 Units Removal, Fixed Bridge, Implant ( New Prosthesis) - 4 Units false false false 0 0 false 66249 22 M Removal, Fixed Bridge, Implant ( New Prosthesis) - Add Unit over 4 Removal, Fixed Bridge, Implant ( New Prosthesis) - Add Unit over 4 false false false 0 0 false 66251 17 M Bridge Repair / Polishing - 1 Unit Bridge Repair / Polishing - 1 Unit false false false 0 0 false 66252 17 M Bridge Repair / Polishing - 2 Units Bridge Repair / Polishing - 2 Units false false false 0 0 false 66253 17 M Bridge Repair / Polishing - 3 Units Bridge Repair / Polishing - 3 Units false false false 0 0 false 66254 17 M Bridge Repair / Polishing - 4 Units Bridge Repair / Polishing - 4 Units false false false 0 0 false 66259 17 M Bridge Repair / Polishing - Add Unit over 4 Bridge Repair / Polishing - Add Unit over 4 false false false 0 0 false 66301 17 M Bridge Repair Recementation - 1 Unit Bridge Repair Recementation - 1 Unit true true false 0 0 1919 0 false 66302 17 M Bridge Repair Recementation - 2 Units Bridge Repair Recementation - 2 Units true true false 0 0 1919 0 false 66303 17 M Bridge Repair Recementation - 3 Units Bridge Repair Recementation - 3 Units true true false 0 0 1919 0 false 66304 17 M Bridge Repair Recementation - 4 Units Bridge Repair Recementation - 4 Units true true false 0 0 1919 0 false 66309 17 M Bridge Recementation - Add Unit over 4 Bridge Recementation - Add Unit over 4 true true false 0 0 1919 0 false 66311 22 M Implant Bridge Repair, Recementation - 1 Unit Implant Bridge Repair, Recementation - 1 Unit true false false 0 0 false 66312 22 M Implant Bridge Repair, Recementation - 2 Units Implant Bridge Repair, Recementation - 2 Units true false false 0 0 false 66313 22 M Implant Bridge Repair, Recementation - 3 Units Implant Bridge Repair, Recementation - 3 Units true false false 0 0 false 66314 22 M Implant Bridge Repair, Recementation - 4 Units Implant Bridge Repair, Recementation - 4 Units true false false 0 0 false 66319 22 M Implant Bridge Repair, Recementation - Add Unit over 4 Implant Bridge Repair, Recementation - Add Unit over 4 true false false 0 0 false 66666 17 M false false false 0 0 1919 0 MODBLIV 0 false 0 66711 17 M Porcelain, Bridge Repair 1st Tooth Porcelain, Bridge Repair 1st Tooth false true false 0 0 1919 0 false 66719 17 M Porcelain, Bridge Repair - Add Tooth Porcelain, Bridge Repair - Add Tooth false true false 0 0 1919 0 false 66721 17 M Repair Broken Solder Joint - 1 Unit Repair Broken Solder Joint - 1 Unit true false false 0 0 false 66729 17 M Repair Broken Solder Joint - Add Unit Repair Broken Solder Joint - Add Unit true false false 0 0 false 66731 17 M Repair Fracture Pontic Repair Fracture Pontic false false false 0 0 1919 0 MODBLIV false 66739 17 M Repair Fracture Pontic,Ad Repair Fracture Pontic,Ad false false false 0 0 1919 0 MODBLIV false 66741 17 M Rep/Fixed,Brid/Proth 1 Un Rep/Fixed,Brid/Proth 1 Un false false false 0 0 1919 0 MODBLIV false 66742 17 M Rep/Fixed,Brid/Proth 2 Un Rep/Fixed,Brid/Proth 2 Un false false false 0 0 1919 0 MODBLIV false 66743 22 M Implant Bridge Fixed Direct - 3 Units Implant Bridge Fixed Direct - 3 Units true false false 0 0 false 66744 22 M Implant Bridge Fixed Direct - 4 Units Implant Bridge Fixed Direct - 4 Units true false false 0 0 false 66749 17 M Rep/Fixed,Brid/Proth Add Rep/Fixed,Brid/Proth Add false false false 0 0 1919 0 MODBLIV false 67101 17 M Retain/Acryl/Proces Retain/Acryl/Proces false false false 0 0 1919 0 MODBLIV false 67102 17 M Retain/Plast/Proces/Metal Retain/Plast/Proces/Metal false false false 0 0 1919 0 MODBLIV false 67111 17 M Retainer, Acrylic, Compomer - Indirect Retainer, Acrylic, Compomer - Indirect true false false 0 0 false 67112 17 M Retainer Complicated Indi Retainer Complicated Indi false false false 0 0 1919 0 MODBLIV false 67113 17 M Acrylic/Composite/Compom Acrylic/Composite/Compom false false false 0 0 1919 0 MODBLIV false 67115 22 M Retainer, Acrylic, Compomer, Implant - Indirect Retainer, Acrylic, Compomer, Implant - Indirect true false false 0 0 1919 0 false 67121 17 M Retainer, Acrylic, Compomer - direct Retainer, Acrylic, Compomer - direct true false false 0 0 1418 0 false 67125 22 M Retainer, Acrylic, Compomer, Implant - direct Retainer, Acrylic, Compomer, Implant - direct true false false 0 0 false 67129 17 M Retain/Acryl/Direct Add. Retain/Acryl/Direct Add. false false false 0 0 1919 0 MODBLIV false 67131 17 M Retainer, Processed to Cast Metal - Indirect Retainer, Processed to Cast Metal - Indirect true true false 0 0 1919 0 false 67135 22 M Retainer, Processed to Cast Metal, Implant - Indirect Retainer, Processed to Cast Metal, Implant - Indirect true false false 0 0 false 67137 17 M Semi-Precision Rest Indir Semi-Precision Rest Indir false false false 0 0 1919 0 MODBLIV false 67138 17 M Semi-Precision/Prec/Attac Semi-Precision/Prec/Attac false false false 0 0 1919 0 MODBLIV false 67139 17 M Retain/Acryl/Indir Add. Retain/Acryl/Indir Add. false false false 0 0 1919 0 MODBLIV false 67141 17 M Retain/Acryl/Indir Implan Retain/Acryl/Indir Implan false false false 0 0 1919 0 MODBLIV false 67145 22 M Retainer, Prefab Metal, Implant - direct Retainer, Prefab Metal, Implant - direct true false false 0 0 false 67149 17 M Retian/Acryl/Indir Add. Retian/Acryl/Indir Add. false false false 0 0 1919 0 MODBLIV false 67155 22 M Retainer, Prefab Metal, Implant - Indirect Retainer, Prefab Metal, Implant - Indirect true false false 0 0 false 67160 17 M Retain/Acryl/Comp/Indirec Retain/Acryl/Comp/Indirec false false false 0 0 1919 0 MODBLIV false 67161 17 M Retainer 2 S Inlay - Indirect Retainer 2 S Inlay - Indirect true false false 0 0 false 67170 17 M Retain/Acryl/Comp/Three Retain/Acryl/Comp/Three false false false 0 0 1919 0 MODBLIV false 67171 17 M Retainer 3 S Inlay - Indirect Retainer 3 S Inlay - Indirect true false false 0 0 false 67180 17 M Retain/Acryl/Comp/Onlay Retain/Acryl/Comp/Onlay false false false 0 0 1919 0 MODBLIV false 67181 17 M Retainer Onlay - Indirect Retainer Onlay - Indirect true false false 0 0 false 67201 17 M Retainer, Porcelain Full Cover Retainer, Porcelain Full Cover true false false 0 0 false 67202 17 M Retainer, Porcelain Full Cover, Complicated Retainer, Porcelain Full Cover, Complicated true true false 0 0 1919 0 false 67205 22 M Retainer, Porcelain Full Cover, Implant Retainer, Porcelain Full Cover, Implant true false false 0 0 false 67211 17 M Retainer, Porcelain Fused to Metal Base Retainer, Porcelain Fused to Metal Base true true false 0 0 1919 0 false 67212 17 M Retainer, Porcelain Fused to Metal, Complicated Retainer, Porcelain Fused to Metal, Complicated true false false 0 0 false 67213 17 M Retain/Porc/Glass/Facial Retain/Porc/Glass/Facial false false false 0 0 1919 0 MODBLIV false 67215 22 M Retainer, Porcelain Fused to Metal, Implant Retainer, Porcelain Fused to Metal, Implant true false false 0 0 false 67217 17 M Semi - Precision Rest ( Interlock ) - Add to Rentainer Semi - Precision Rest ( Interlock ) - Add to Rentainer true false false 0 0 false 67218 17 M Semi - Precision / Precision Attach, RPD Retainer Semi - Precision / Precision Attach, RPD Retainer true false false 0 0 false 67221 17 M Retainer, Porcelain, Partial Cover, Bonded Retainer, Porcelain, Partial Cover, Bonded true true false 0 0 1919 0 false 67229 17 M Retain/Porc/Metal Add. Retain/Porc/Metal Add. false false false 0 0 1919 0 MODBLIV false 67231 17 M Retainer, Porcelain, 2 S Inlay, Bonded Retainer, Porcelain, 2 S Inlay, Bonded true false false 0 0 false 67241 17 M Retainer, Porcelain 3 S Inlay, Bonded Retainer, Porcelain 3 S Inlay, Bonded true false false 0 0 false 67251 17 M Retainer, Porcelain Onlay, Bonded Retainer, Porcelain Onlay, Bonded true false false 0 0 false 67301 17 M Retainer, Full, Cast Metal Retainer, Full, Cast Metal true true false 0 0 1919 0 false 67302 17 M Retain/Metal/Stress Break Retain/Metal/Stress Break false false false 0 0 1919 0 MODBLIV false 67305 22 M Retainers, Full, Cast Metal, Implant Retainers, Full, Cast Metal, Implant true false false 0 0 false 67307 17 M Semi-Precision/Rest Semi-Precision/Rest false false false 0 0 1919 0 MODBLIV false 67308 17 M Full Cast Metal, Semi-Pre Full Cast Metal, Semi-Pre false false false 0 0 1919 0 MODBLIV false 67311 17 M Retainer, 3/4, Cast Metal + L Retainer, 3/4, Cast Metal + L true false false 0 0 1919 0 false 67312 17 M Retainers Retainers false false false 0 0 1919 0 MODBLIV false 67317 17 M Semi - precision or Precision Rest ( interlock ) Semi - precision or Precision Rest ( interlock ) true false false 0 0 1919 0 false 67318 17 M Semi - precision or Precision Attach, RPD Retainer Semi - precision or Precision Attach, RPD Retainer true false false 0 0 1919 0 false 67321 17 M Retainer, Cast Metal Inlay - 2 S Retainer, Cast Metal Inlay - 2 S true false false 0 0 false 67322 17 M Retainer, Cast Metal Inlay - 3 S & Up Retainer, Cast Metal Inlay - 3 S & Up true false false 0 0 false 67327 17 M Retain/Metal/Semi-Prec In Retain/Metal/Semi-Prec In false false false 0 0 1919 0 MODBLIV false 67331 17 M Retainer Metal Onlay Retainer Metal Onlay true false false 0 0 1919 0 false 67337 17 M Retain/Mtl/Onlay/Semi,Res Retain/Mtl/Onlay/Semi,Res false false false 0 0 1919 0 MODBLIV false 67338 17 M Retain/Mtl/Onlay/Semi,Att Retain/Mtl/Onlay/Semi,Att false false false 0 0 1919 0 MODBLIV false 67341 17 M Retainer, Cast Metal Onlay, Bonded to Abutment Tooth Retainer, Cast Metal Onlay, Bonded to Abutment Tooth true true false 0 0 1919 0 false 67351 17 M Retain/Met/Pref/Trans 1 Retain/Met/Pref/Trans 1 false false false 0 0 1919 0 MODBLIV false 67355 17 M Retain/Met/Pref/No Occlus Retain/Met/Pref/No Occlus false false false 0 0 1919 0 MODBLIV false 67359 17 M Retain/Met/Pref/Trans Add Retain/Met/Pref/Trans Add false false false 0 0 1919 0 MODBLIV false 67401 17 M Retainers/Metal/Cust/Cast Retainers/Metal/Cust/Cast false false false 0 0 1919 0 MODBLIV false 67411 17 M Retainers/Metal/Cust/Cast Retainers/Metal/Cust/Cast false false false 0 0 1919 0 MODBLIV false 67415 22 M Retainer, Metal, Prefab, Implant w/ no Occlusal Component Retainer, Metal, Prefab, Implant w/ no Occlusal Component true false false 0 0 1919 0 false 67501 17 M Abutment Preparation Under Existing Partial Denture Clasp Abutment Preparation Under Existing Partial Denture Clasp true true false 0 0 1468 0 false 67502 17 M Telescoping Crown Unit Telescoping Crown Unit true true false 0 0 1468 0 false 67503 17 M Implant/Bar/Screws Implant/Bar/Screws false false false 0 0 1919 0 MODBLIV false 69101 17 M Fixed Prosth/Porcelain Fixed Prosth/Porcelain false false false 0 0 1919 0 MODBLIV false 69201 17 M Fix Splinting - Per Tooth Fix Splinting - Per Tooth true true false 0 0 1919 0 false 69301 17 M Fix Retentive Pin - 1 Retentive Pin Fix Retentive Pin - 1 Retentive Pin true true false 0 0 1468 0 false 69302 17 M Fix Retentive Pin - 2 Retentive Pin Fix Retentive Pin - 2 Retentive Pin true true false 0 0 1468 0 false 69303 17 M Fix Retentive Pin - 3 Retentive Pin Fix Retentive Pin - 3 Retentive Pin true true false 0 0 1468 0 false 69304 17 M Fix Retentive Pin - 4 Retentive Pin Fix Retentive Pin - 4 Retentive Pin true true false 0 0 1468 0 false 69305 17 M Fix Retentive Pin - 5 Retentive Pin & Up Fix Retentive Pin - 5 Retentive Pin & Up true true false 0 0 1468 0 false 69401 17 M Staining, Porcelain - 1 Unit Staining, Porcelain - 1 Unit false false false 0 0 1919 0 false 69402 17 M Staining Porcelain/2 Unit Staining Porcelain/2 Unit false false false 0 0 1919 0 MODBLIV false 69403 17 M Staining Porcelain/3 Unit Staining Porcelain/3 Unit false false false 0 0 1919 0 MODBLIV false 69404 17 M Staining Porcelain/4 Unit Staining Porcelain/4 Unit false false false 0 0 1919 0 MODBLIV false 69409 17 M Staining,Porcelain - Each Add Unit over 1 Staining, Porcelain- Each Add Unit over 1 false false false 0 0 1919 0 false 69601 17 M Fixed Prosth/Sur/Max Arch Fixed Prosth/Sur/Max Arch false false false 0 0 1919 0 MODBLIV false 69602 17 M Fixed Prosth/Sur/Man Arch Fixed Prosth/Sur/Man Arch false false false 0 0 1919 0 MODBLIV false 69701 17 M Fixed Prosthetics, Provisional Coverage - Abutment Tooth Fixed Prosthetics, Provisional Coverage - Abutment Tooth true true false 0 0 1468 0 false 69702 17 M Fixed Prosthetics, Provisional Coverage - Pontic Fixed Prosthetics, Provisional Coverage - Pontic true true false 0 0 1468 0 false 69811 22 M Fixed Prostho Framework Attach w/ Screws - Max Fixed Prostho Framework Attach w/ Screws - Max true true false 0 3 0011 0 false 69812 22 M Fixed Prostho Framework Attach w/ Screws - Mand Fixed Prostho Framework Attach w/ Screws - Mand true true false 0 3 0022 0 false 69819 17 M Frame/Screw/Acryl/Add Abu Frame/Screw/Acryl/Add Abu false false false 0 0 1919 0 MODBLIV false 69821 22 M Fixed Prostho Framework Attach w/ Screws / Cement - Max Fixed Prostho Framework Attach w/ Screws / Cement - Max true true false 0 2 0011 0 false 69822 22 M Fixed Prostho Framework Attach w/ Screws / Cement - Mand Fixed Prostho Framework Attach w/ Screws / Cement - Mand true true false 0 3 0022 0 false 69831 17 M Remov/Imp/Screw/Clean Un Remov/Imp/Screw/Clean Un false false false 0 0 1919 0 MODBLIV false 69839 17 M Remov/Imp/Screw/Clean Add Remov/Imp/Screw/Clean Add false false false 0 0 1919 0 MODBLIV false 69841 17 M Reinsert/Imp/Screw 1 Un Reinsert/Imp/Screw 1 Un false false false 0 0 1919 0 MODBLIV false 69849 17 M Reinsert/Imp/Screw Add Un Reinsert/Imp/Screw Add Un false false false 0 0 1919 0 MODBLIV false 70000 18 B Tx Non Specified Tx Non Specified false false false 0 0 1919 0 MODBLIV false 70010 18 B Cancelled Appt Cancelled Appt false false false 0 0 1919 0 MODBLIV false 70020 18 B House Call House Call false false false 0 0 1919 0 MODBLIV false 70030 18 B Travelling Expense Travelling Expense false false false 0 0 1919 0 MODBLIV false 70040 18 B Office Visit Office Visit false false false 0 0 1919 0 MODBLIV false 70050 18 B Professional Consultation Professional Consultation false false false 0 0 1919 0 MODBLIV false 70060 18 B Written Report Written Report false false false 0 0 1919 0 MODBLIV false 70070 18 B Completing Claim Form Completing Claim Form false false false 0 0 1919 0 MODBLIV false 70080 18 B Court Appearance Court Appearance false false false 0 0 1919 0 MODBLIV false 70100 18 B Mngment/Acute Oral Infect Mngment/Acute Oral Infect false false false 0 0 1919 MODBLIV false 70200 18 B Desensitization Desensitization false false false 0 0 1919 MODBLIV false 71000 18 B Cast Clasp Cast Clasp false false false 0 0 1919 0 MODBLIV false 71010 18 B Wrought Clasp Wrought Clasp false false false 0 0 1919 0 MODBLIV false 71020 18 B Gold Cast Clasp Gold Cast Clasp false false false 0 0 1919 0 MODBLIV false 71021 18 B Gold Wrought Clasp Gold Wrought Clasp false false false 0 0 1919 0 MODBLIV false 71030 18 B Thermal Elastic Frict. Cl Thermal Elastic Frict. Cl false false false 0 0 1919 0 MODBLIV false 71031 18 B Thermal Elastic Gasket Cl Thermal Elastic Gasket Cl false false false 0 0 1919 0 MODBLIV false 71040 18 B Precision Attachments Precision Attachments false false false 0 0 1919 0 MODBLIV false 71050 18 B Overdenture Attachments Overdenture Attachments false false false 0 0 1919 0 MODBLIV false 71060 18 B Combined Magnetic Repel Combined Magnetic Repel false false false 0 0 1919 0 MODBLIV false 71070 18 B Mand Myoloc System Mand Myoloc System false false false 0 0 1919 0 MODBLIV false 71100 18 B Case Type 1 (gingivitis) Case Type 1 (gingivitis) false false false 0 0 1919 MODBLIV false 71101 18 B Exo, Single Tooth, Uncomplicated Exo, Single Tooth, Uncomplicated false true false 0 0 1818 0 false 71102 18 B Extractions, Twoteeth Extractions, Twoteeth false false false 0 0 1919 0 MODBLIV false 71103 18 B Extractions, Three Teeth Extractions, Three Teeth false false false 0 0 1919 0 MODBLIV false 71104 18 B Extractions, Four Teeth Extractions, Four Teeth false false false 0 0 1919 0 MODBLIV false 71105 18 B Extractions, Single Tooth Extractions, Single Tooth false false false 0 0 1919 0 MODBLIV false 71107 18 B Extraction Add Prim Tooth Extraction Add Prim Tooth false false false 0 0 1919 0 MODBLIV false 71108 18 B Removal or first tooth in each quadrant uncomplicated Removal or first tooth in each quadrant uncomplicated false false false 0 0 false 0 71109 18 B Exo, Add Tooth Same Quadrant Exo, Add Tooth Same Quadrant false true false 0 0 1818 0 false 71200 18 B Case Type 1a (ging W/Com) Case Type 1a (ging W/Com) false false false 0 0 1919 MODBLIV false 71201 18 B Odontectomy, Surgical Flap Odontectomy, Surgical Flap false true false 0 0 1818 0 false 71209 18 B Odontectomy, Surgical Flap - Add Tooth Same Quadrant Odontectomy, Surgical Flap - Add Tooth Same Quadrant false true false 0 0 1818 0 false 71211 18 B Elevation of Flap, Remove Bone & Section Tooth Elevation of Flap, Remove Bone & Section Tooth false true false 0 0 1818 0 false 71219 18 B Elevation of Flap, Remove Bone & Section Tooth - Add Tooth Elevation of Flap, Remove Bone & Section Tooth - Add Tooth false true false 0 0 1818 0 false 71300 18 B Case Type 1 In Hosp 15 Mn Case Type 1 In Hosp 15 Mn false false false 0 0 1919 MODBLIV false 71400 18 B Case Type 1a Hosp W/Comp Case Type 1a Hosp W/Comp false false false 0 0 1919 MODBLIV false 72000 18 B Mesh Palate Reinforcement Mesh Palate Reinforcement false false false 0 0 1919 0 MODBLIV false 72010 18 B Cast Palate Reinforcement Cast Palate Reinforcement false false false 0 0 1919 0 MODBLIV false 72020 18 B Lingual Bar Reinforce. Lingual Bar Reinforce. false false false 0 0 1919 0 MODBLIV false 72030 18 B Mand Cast Base Reinforce. Mand Cast Base Reinforce. false false false 0 0 1919 0 MODBLIV false 72031 18 B Mand Cast Mesh Reinforce. Mand Cast Mesh Reinforce. false false false 0 0 1919 0 MODBLIV false 72040 18 B Impact Resist Acr Impact Resist Acr false false false 0 0 1919 0 MODBLIV false 72050 18 B Metal Posteriors Metal Posteriors false false false 0 0 1919 0 MODBLIV false 72051 18 B Cutter Bars Cutter Bars false false false 0 0 1919 0 MODBLIV false 72060 18 B Backings/Faings Backings/Faings false false false 0 0 1919 0 MODBLIV false 72111 18 B Sofe Tissue Coverage Sofe Tissue Coverage false true false 0 0 1818 0 false 72119 18 B Sofe Tissue Coverage - Add Tooth Sofe Tissue Coverage - Add Tooth false true false 0 0 1818 0 false 72211 18 B Bone Removal or Sectioning of Tooth Bone Removal or Sectioning of Tooth false true false 0 0 1818 0 false 72219 18 B Bone Removal or Sectioning of Tooth - Add Tooth Bone Removal or Sectioning of Tooth - Add Tooth false true false 0 0 1818 0 false 72221 18 B Bone Removal & Sectioning of Tooth Bone Removal & Sectioning of Tooth false true false 0 0 1818 0 false 72229 18 B Bone Removal & Sectioning of Tooth Bone Removal & Sectioning of Tooth false true false 0 0 1818 0 false 72231 18 B Extraction,Complete Impac Extraction,Complete Impac false false false 0 0 1919 0 MODBLIV false 72239 18 B Extraction,Complete Impac Extraction,Complete Impac false false false 0 0 1919 0 MODBLIV false 72311 18 B Removal, Residual Roots, Erupted - 1st Tooth Removal, Residual Roots, Erupted - 1st Tooth false true false 0 0 1818 0 false 72319 18 B Removal, Residual Roots, Erupted - Add Tooth Removal, Residual Roots, Erupted - Add Tooth false true false 0 0 1818 0 false 72321 18 B Removal, Residual Roots, Soft Tissue - 1st Tooth Removal, Residual Roots, Soft Tissue - 1st Tooth false true false 0 0 1818 0 false 72329 18 B Removal, Residual Roots, Soft Tissue - Add Tooth Removal, Residual Roots, Soft Tissue - Add Tooth false true false 0 0 1818 0 false 72331 18 B Removal, Residual Root, Bone Tissue - 1st Tooth Removal, Residual Root, Bone Tissue - 1st Tooth false true false 0 0 1818 0 false 72339 18 B Removal, Residual Root, Bone Tissue - Add Tooth Removal, Residual Root, Bone Tissue - Add Tooth false true false 0 0 1818 0 false 72400 18 B Oral Surgery/Unit=15 Mins Oral Surgery/Unit=15 Mins false false false 0 0 1919 MODBLIV false 72410 18 B Post Extract/Simple Ridge Post Extract/Simple Ridge false false false 0 0 1919 0 MODBLIV false 72411 18 B Simple Ridge Preservation, Alloplastic Material - 1st Tooth Simple Ridge Preservation, Alloplastic Material - 1st Tooth true true false 0 0 1818 0 false 72419 18 B Simple Ridge Preservation, Alloplastic Material - Add Tooth Simple Ridge Preservation, Alloplastic Material - Add Tooth true true false 0 0 1818 0 false 72420 18 B Alveolar Bone Preservation - Allograft Alveolar Bone Preservation - Allograft false false false 0 0 false 0 72421 18 B First tooth + E First tooth + E false false false 0 0 false 0 72429 18 B Eath additional tooth + E Eath additional tooth + E false false false 0 0 false 0 72430 18 B Alveolar Bone Presevation - Zenograft Alveolar Bone Presevation - Zenograft false false false 0 0 false 0 72431 18 B First tooth + E First tooth + E false false false 0 0 false 0 72439 18 B Each additional tooth + E Each additional tooth + E false false false 0 0 false 0 72511 18 B Surgical Exposure of Teeth, Enerupted,Uncomplicated Soft Tissue-Single Tooth Surgical Exposure of Teeth, Enerupted,Uncomplicated Soft Tissue-Single Tooth false true false 0 0 1818 0 false 72519 18 B Surgical Exposure of Teeth, Enerupted,Uncomplicated Soft Tissue-Each Add Tooth, Same Quadrant Surgical Exposure of Teeth, Enerupted,Uncomplicated Soft Tissue-Each Add Tooth, Same Quadrant false true false 0 0 1818 0 false 72521 18 B Surgical Exposure,Complex, Hard Tissue-Single Coverage- Single Tooth Surgical Exposure,Complex, Hard Tissue-Single Coverage- Single Tooth false true false 0 0 1818 0 false 72529 18 B Surgical Exposure,Complex, Hard Tissue-Single Coverage- Each Add Tooth, Same Quadrant Surgical Exposure,Complex, Hard Tissue-Single Coverage- Each Add Tooth, Same Quadrant false true false 0 0 1818 0 false 72531 18 B Surgical Exposure W/Ortho Surgical Exposure W/Ortho false false false 0 0 1919 0 MODBLIV false 72539 18 B Surgical Exposure W/Orth Surgical Exposure W/Orth false false false 0 0 1919 0 MODBLIV false 72541 18 B Surgical Exposure Of Toot Surgical Exposure Of Toot false false false 0 0 1919 0 MODBLIV false 72551 18 B Surgical Exposure Of Toot Surgical Exposure Of Toot false false false 0 0 1919 0 MODBLIV false 72561 18 B Anchorage Device Ortho Appl Place without elevat of flap false false false 0 0 false 0 72562 18 B Anchorage Device Ortho Appl Place with elevation of flap false false false 0 0 false 0 72563 18 B Anchorage Device Ortho Appl Remove without elevat of flap false false false 0 0 false 0 72564 18 B Anchorage Device Ortho Appl Remove with elevation of flap false false false 0 0 false 0 72611 18 B Surgical Movement, Transplantation of Erupted Tooth-1st Tooth Surgical Movement, Transplantation of Erupted Tooth-1st Tooth false true false 0 0 1818 0 false 72619 18 B Transplantation Of Erupte Transplantation Of Erupte false false false 0 0 1919 0 MODBLIV false 72621 18 B Surgical Movement- Transplantation of Unerupted Tooth-1st Tooth Surgical Movement- Transplantation of Unerupted Tooth-1st Tooth false true false 0 0 1818 0 false 72629 18 B Transplantation Of Unerup Transplantation Of Unerup false false false 0 0 1919 MODBLIV false 72631 18 B Surgical Reposition Of To Surgical Reposition Of To false false false 0 0 1919 0 MODBLIV false 72639 18 B Repositioning Of Tooth Repositioning Of Tooth false false false 0 0 1919 0 MODBLIV false 72641 18 B Enucleation Enucleation false true false 0 0 1818 0 false 72649 18 B Enucleat/Surgical Add. Enucleat/Surgical Add. false false false 0 0 1919 0 MODBLIV false 72711 18 B Enucleation, Surgical, Unerupted Tooth&Follicle-1st Tooth Enucleation, Surgical, Unerupted Tooth&Follicle-1st Tooth false true false 0 0 1818 0 false 72719 18 B Enucleation, Surgical, Unerupted Tooth&Follicle-Each Additional Tooth, Same Quadrant Enucleation, Surgical, Unerupted Tooth&Follicle-Each Additional Tooth, Same Quadrant false true false 0 0 1818 0 false 72801 18 B Removal of a Frractured CUSP as a Separate Procedure - 1st tooth Removal of a Frractured CUSP as a Separate Procedure - 1st tooth false false false 0 0 false 72809 18 M Removal of a Frractured CUSP as a Separate Procedure - Additional tooth, same quadrant Removal of a Frractured CUSP as a Separate Procedure - Additional tooth, same quadrant false false false 0 0 false 73000 18 B Soft-Lining-New Denture Soft-Lining-New Denture false false false 0 0 1919 0 MODBLIV false 73010 18 B Soft Lining - Relining Soft Lining - Relining false false false 0 0 1919 0 MODBLIV false 73011 18 B Soft Lining - Light Cured Soft Lining - Light Cured false false false 0 0 1919 0 MODBLIV false 73012 18 B Cu-Sil Cu-Sil false false false 0 0 1919 0 MODBLIV false 73013 18 B Soft Lining - Rebase Soft Lining - Rebase false false false 0 0 1919 0 MODBLIV false 73020 18 B Clear Palate Clear Palate false false false 0 0 1919 0 MODBLIV false 73030 18 B Gingival Toning Gingival Toning false false false 0 0 1919 0 MODBLIV false 73040 18 B Gold Inlays Gold Inlays false false false 0 0 1919 0 MODBLIV false 73041 18 B Amalgam Inlays Amalgam Inlays false false false 0 0 1919 0 MODBLIV false 73050 18 B Name In Denture Name In Denture false false false 0 0 1919 0 MODBLIV false 73060 18 B Clean And Polish Clean And Polish false false false 0 0 1919 0 MODBLIV false 73070 18 B Replace Worn Posterior Replace Worn Posterior false false false 0 0 1919 0 MODBLIV false 73111 18 B Alveoloplasty,in Conjunction W/Multiple Extractions,Per Site Alveoloplasty,in Conjunction W/Multiple Extractions,Per Site false true false 0 0 1919 0 false 73121 18 B Alveoloplasty, not in Conjunction W/Multiple Extractions,Per Site Alveoloplasty,not in Conjunction W/Multiple Extractions,Per Site false true false 0 0 1818 0 false 73141 18 B Mylohyoid Ridge Remodelli Mylohyoid Ridge Remodelli false false false 0 0 1919 MODBLIV false 73142 18 B Genial Tubercles Remodell Genial Tubercles Remodell false false false 0 0 1919 MODBLIV false 73151 18 B Excision Of Nasal Spine Excision Of Nasal Spine false false false 0 0 1919 MODBLIV false 73152 18 B Excision of Bone,Torus Palatinus,Excision Excision of Bone,Torus Palatinus,Excision false true false 0 0 1818 0 false 73153 18 B Excision of Bone,Torus Mandibularis,Unilateral, Excision Excision of Bone,Torus Mandibularis,Unilateral, Excision false true false 0 0 1818 0 false 73154 18 B Excision of Bone,Torus Mandibularis,Bilateral, Excision Excision of Bone,Torus Mandibularis,Bilateral, Excision false true false 0 0 1818 0 false 73161 18 B Removal of Bone,Exostosis, Multiple,Per Quadrant Removal of Bone,Exostosis, Multiple,Per Quadrant false true false 0 1 1400 0 false 73171 18 B Reduction Of Bone,Tuberosity, Unilateral Reduction Of Bone,Tuberosity, Unilateral false true false 0 0 1818 0 false 73172 18 B Reduction Of Bone,Tuberosity, Bilateral Reduction Of Bone,Tuberosity, Bilateral false true false 0 0 1818 0 false 73181 18 B Augmentation of Bone, Unilateral,Ptergomaxillary Tuberosity Augmentation of Bone, Unilateral,Ptergomaxillary Tuberosity true true false 0 0 1818 0 false 73182 18 B Augmentation of Bone, Bilateral,Ptergomaxillary Tuberosity Augmentation of Bone, Bilateral,Ptergomaxillary Tuberosity true true false 0 0 1818 0 false 73183 18 B Augmentation of Bone, Unilateral,Mandibular Ridge Augmentation of Bone, Unilateral,Mandibular Ridge true true false 0 0 1818 0 false 73184 18 B Augmentation of Bone, Bilateral,Mandibular Ridge Augmentation of Bone, Bilateral,Mandibular Ridge true true false 0 0 1818 0 false 73211 18 B Gingivoplasty And/Or Stom Gingivoplasty And/Or Stom false false false 0 0 1919 0 MODBLIV false 73221 18 B Gingivoplasty/Stomatoplas Gingivoplasty/Stomatoplas false false false 0 0 1919 0 MODBLIV false 73222 18 B Excision of Vestibular Hyperplasia, Per Site Excision of Vestibular Hyperplasia, Per Site false true false 0 0 1818 0 false 73223 18 B Surgical Shave of Papillary Hyperplasia of Plate, Excicion of Pericoronal Gingiva,Per Tooth/Implant Surgical Shave of Papillary Hyperplasia of Plate, Excicion of Pericoronal Gingiva,Per Tooth/Implant false true false 0 0 1818 0 false 73224 18 B Excision of Pericoronal Gigiva, Per Tooth/Implant Excision of Pericoronal Gigiva, Per Tooth/Implant false true false 0 0 1818 0 false 73231 18 B Removals,Tissue,Hyperplastic, Per Site Removals,Tissue,Hyperplastic, Per Site false true false 0 0 1818 0 false 73240 18 B Removal,Mucosa,Per Sextnt Removal,Mucosa,Per Sextnt false false false 0 0 1919 MODBLIV false 73241 18 B Removal Of Excess Mucosa Removal Of Excess Mucosa false false false 0 0 1919 MODBLIV false 73301 18 B Full Arch Lowering Of Th Full Arch Lowering Of Th false false false 0 0 1919 MODBLIV false 73302 18 B Partial Arch Lowering Of Partial Arch Lowering Of false false false 0 0 1919 MODBLIV false 73303 18 B Reinsertion Of The Myloh Reinsertion Of The Myloh false false false 0 0 1919 MODBLIV false 73411 18 B Sub-Mucous Vestibuloplast Sub-Mucous Vestibuloplast false false false 0 0 1919 0 MODBLIV false 73421 18 B Vestibuloplasty,Sulcus Deepening&Ridge Reconstruction Vestibuloplasty,Sulcus Deepening&Ridge Reconstruction false true false 0 0 1818 0 false 73431 18 B Vestibuloplasty Vestibuloplasty false false false 0 0 1919 0 MODBLIV false 73440 18 B Vest. W/Labial Flap/Sext. Vest. W/Labial Flap/Sext. false false false 0 0 1919 MODBLIV false 73441 18 B Vestibuloplasty W/Labial Vestibuloplasty W/Labial false false false 0 0 1919 MODBLIV false 73450 18 B Vest. W/Skin Graft/Sext. Vest. W/Skin Graft/Sext. false false false 0 0 1919 MODBLIV false 73451 18 B Vestibuloplasty W/Skin Gr Vestibuloplasty W/Skin Gr false false false 0 0 1919 MODBLIV false 73460 18 B Vest. W/Mucos Graft/Sext. Vest. W/Mucos Graft/Sext. false false false 0 0 1919 MODBLIV false 73461 18 B Vestibuloplasty W/Mucosal Vestibuloplasty W/Mucosal false false false 0 0 1919 MODBLIV false 73470 18 B Vestibuloplasty - with Dermal Graft - Autograft Vestibuloplasty - with Dermal Graft - Autograft false false false 0 0 false 0 73471 18 B Per Sextant Per Sextant false false false 0 0 false 0 73480 18 B Vestibuloplasty - with Dermal Graft - Allograft Vestibuloplasty - with Dermal Graft - Allograft false false false 0 0 false 0 73481 18 B Per Sextant Per Sextant false false false 0 0 false 0 73490 18 B Vestibuloplasty - with Connective Tissue for Ridge Augmentation Vestibuloplasty - with Connective Tissue for Ridge Augmentation false false false 0 0 false 0 73491 18 B Per sextant Per sextant false false false 0 0 false 0 73511 18 B With Autogenous Bone - P With Autogenous Bone - P false false false 0 0 1919 MODBLIV false 73521 18 B With Alloplastic Material With Alloplastic Material false false false 0 0 1919 MODBLIV false 73611 18 B With Secondary Epitheliza With Secondary Epitheliza false false false 0 0 1919 MODBLIV false 73621 18 B With Skin Grafts - Per Se With Skin Grafts - Per Se false false false 0 0 1919 MODBLIV false 73631 18 B With Mucous Graft -Per Se With Mucous Graft -Per Se false false false 0 0 1919 MODBLIV false 73711 18 B Cleft Repair, Sliding Pal Cleft Repair, Sliding Pal false false false 0 0 1919 0 MODBLIV false 73712 18 B Cleft Repair, Arterial Is Cleft Repair, Arterial Is false false false 0 0 1919 0 MODBLIV false 73721 18 B Secondary Repair, Alveolu Secondary Repair, Alveolu false false false 0 0 1919 0 MODBLIV false 73722 18 B Secondary Repair, Alveolu Secondary Repair, Alveolu false false false 0 0 1919 0 MODBLIV false 73731 18 B Sec. Repair, Palate, Alv Sec. Repair, Palate, Alv false false false 0 0 1919 0 MODBLIV false 73732 18 B Sec. Repair, Palate, Alve Sec. Repair, Palate, Alve false false false 0 0 1919 0 MODBLIV false 74000 18 B Surgical Template Surgical Template false false false 0 0 1919 0 MODBLIV false 74010 18 B Mouth Guard Mouth Guard false false false 0 0 1919 0 MODBLIV false 74011 18 B Night Guard Night Guard false false false 0 0 1919 0 MODBLIV false 74012 18 B Night Guard, Acr Night Guard, Acr false false false 0 0 1919 0 MODBLIV false 74020 18 B Occlusal Plane Occlusal Plane false false false 0 0 1919 0 MODBLIV false 74030 18 B Occlusal Tx Splints Occlusal Tx Splints false false false 0 0 1919 0 MODBLIV false 74040 18 B Cross Bar Cross Bar false false false 0 0 1919 0 MODBLIV false 74050 18 B Anti-Snoring Device Anti-Snoring Device false false false 0 0 1919 0 MODBLIV false 74111 18 B Surgical Excision,Tumour, Benign,Scar Tissue, Inflame/ Congenital Lesion of Soft Tissue of Oral Cavity-1cm& Under Surgical Excision,Tumour, Benign,Scar Tissue, Inflame/ Congenital Lesion of Soft Tissue of Oral Cavity-1cm& Under false false false 0 0 false 74112 18 B Surgical Excision,Tumour, Benign,Scar Tissue, Inflame/ Congenital Lesion of Soft Tissue of Oral Cavity-1-2cm Surgical Excision,Tumour, Benign,Scar Tissue, Inflame/ Congenital Lesion of Soft Tissue of Oral Cavity-1-2cm false false false 0 0 false 74113 18 B Scar Tissue, Soft Tissue Scar Tissue, Soft Tissue false false false 0 0 1919 0 MODBLIV false 74114 18 B Scar Tissue, Soft Tissue Scar Tissue, Soft Tissue false false false 0 0 1919 0 MODBLIV false 74115 18 B Scar Tissue, Soft Tissue Scar Tissue, Soft Tissue false false false 0 0 1919 0 MODBLIV false 74116 18 B Scar Tissue, Soft Tissue Scar Tissue, Soft Tissue false false false 0 0 1919 0 MODBLIV false 74117 18 B Scar Tissue, Soft Tissue Scar Tissue, Soft Tissue false false false 0 0 1919 0 MODBLIV false 74118 18 B Scar Tissue, Soft Tissue Scar Tissue, Soft Tissue false false false 0 0 1919 0 MODBLIV false 74121 18 B Surgical Excision,Tumour, Benign,Bone Tissue-1cm& Under Surgical Excision,Tumour, Benign,Bone Tissue-1cm& Under false false false 0 0 1919 0 false 74122 18 B Surgical Excision,Tumour, Benign,Bone Tissue-1-2cm Surgical Excision,Tumour, Benign,Bone Tissue-1-2cm false false false 0 0 1919 0 false 74123 18 B Bone Tissue - 2-3 Cm Bone Tissue - 2-3 Cm false false false 0 0 1919 MODBLIV false 74124 18 B Bone Tissue - 3-4 Cm Bone Tissue - 3-4 Cm false false false 0 0 1919 MODBLIV false 74125 18 B Bone Tissue - 4-6 Cm Bone Tissue - 4-6 Cm false false false 0 0 1919 MODBLIV false 74126 18 B Bone Tissue - 6-9 Cm Bone Tissue - 6-9 Cm false false false 0 0 1919 MODBLIV false 74127 18 B Bone Tissue - 9-15 Cm Bone Tissue - 9-15 Cm false false false 0 0 1919 MODBLIV false 74128 18 B Bone Tissue - 15 Cm And Bone Tissue - 15 Cm And false false false 0 0 1919 MODBLIV false 74211 18 B Tumor,Malignant,Soft Tiss Tumor,Malignant,Soft Tiss false false false 0 0 1919 MODBLIV false 74212 18 B Surg.Excision-Malignant T Surg.Excision-Malignant T false false false 0 0 1919 MODBLIV false 74213 18 B Soft Tissue, Oral Cavity Soft Tissue, Oral Cavity false false false 0 0 1919 MODBLIV false 74214 18 B Soft Tissue, Oral Cavity Soft Tissue, Oral Cavity false false false 0 0 1919 MODBLIV false 74215 18 B Soft Tissue, Oral Cavity Soft Tissue, Oral Cavity false false false 0 0 1919 MODBLIV false 74216 18 B Soft Tissue, Oral Cavity Soft Tissue, Oral Cavity false false false 0 0 1919 MODBLIV false 74217 18 B Soft Tissue, Oral Cavity Soft Tissue, Oral Cavity false false false 0 0 1919 MODBLIV false 74218 18 B Soft Tissue, Oral Cavity Soft Tissue, Oral Cavity false false false 0 0 1919 MODBLIV false 74221 18 B Tumor,Malignant,Bone Tiss Tumor,Malignant,Bone Tiss false false false 0 0 1919 MODBLIV false 74222 18 B Bone Tissue - 1-2 Cm Bone Tissue - 1-2 Cm false false false 0 0 1919 MODBLIV false 74223 18 B Bone Tissue - 2-3 Cm Bone Tissue - 2-3 Cm false false false 0 0 1919 MODBLIV false 74224 18 B Bone Tissue - 3-4 Cm Bone Tissue - 3-4 Cm false false false 0 0 1919 MODBLIV false 74225 18 B Bone Tissue - 4-6 Cm Bone Tissue - 4-6 Cm false false false 0 0 1919 MODBLIV false 74226 18 B Bone Tissue - 6-9 Cm Bone Tissue - 6-9 Cm false false false 0 0 1919 MODBLIV false 74227 18 B Bone Tissue - 9-15 Cm Bone Tissue - 9-15 Cm false false false 0 0 1919 MODBLIV false 74228 18 B Bone Tissue - 15 Cm And Bone Tissue - 15 Cm And false false false 0 0 1919 MODBLIV false 74301 18 B Cheiloplasty, Partial Cheiloplasty, Partial false false false 0 0 1919 MODBLIV false 74302 18 B Cheiloplasty, Total Cheiloplasty, Total false false false 0 0 1919 MODBLIV false 74400 18 B HARD TISSUE GRAFTS TO THE JAW HARD TISSUE GRAFTS TO THE JAW false false false 0 0 false 0 74401 18 B Grafts, Bone, To The Jaw Grafts, Bone, To The Jaw false false false 0 0 1919 MODBLIV false 74402 18 B Allograft - per site - Maxilla or Mandible + E Allograft - per site - Maxilla or Mandible + E false false false 0 0 false 0 74403 18 B Xenograft - per site - Maxilla or Mandible + E Xenograft - per site - Maxilla or Mandible + E false false false 0 0 false 0 74511 18 B Intraosseous Prosthesis - Intraosseous Prosthesis - false false false 0 0 1919 0 MODBLIV false 74512 18 B Intraosseous Prosthesis Intraosseous Prosthesis false false false 0 0 1919 0 MODBLIV false 74521 18 B Augmentation, Synthetic, Augmentation, Synthetic, false false false 0 0 1919 MODBLIV false 74611 18 B Surgical Excision,Cysts/ Granulomas, Enucleation of, Odontogenic&Non-Odontogenic,Prior Remove Bony Tissue&Suture(s)-1cm& Under Surgical Excision,Cysts/ Granulomas ,Enucleation of, Odontogenic&Non-Odontogenic,Prior Remove Bony Tissue&Suture(s)-1cm& Under false false false 0 0 1919 0 false 74612 18 B Surgical Excision,Cysts/ Granulomas, Enucleation of, Odontogenic&Non-Odontogenic,Prior Remove Bony Tissue&Suture(s)-1-2cm Surgical Excision,Cysts/ Granulomas, Enucleation of, Odontogenic&Non-Odontogenic,Prior Remove Bony Tissue&Suture(s)-1-2cm false false false 0 0 1919 0 false 74613 18 B Odontogenic & Non-Odonge Odontogenic & Non-Odonge false false false 0 0 1919 MODBLIV false 74614 18 B Odontogenic & Non-Odonge Odontogenic & Non-Odonge false false false 0 0 1919 MODBLIV false 74615 18 B Odontogenic & Non-Odonge Odontogenic & Non-Odonge false false false 0 0 1919 MODBLIV false 74616 18 B Odontogenic & Non-Odonge Odontogenic & Non-Odonge false false false 0 0 1919 MODBLIV false 74617 18 B Odontogenic & Non-Odonge Odontogenic & Non-Odonge false false false 0 0 1919 MODBLIV false 74618 18 B Odontogenic & Non-Odonge Odontogenic & Non-Odonge false false false 0 0 1919 MODBLIV false 74621 18 B Surgical Excision,Cysts, Marsupialization Surgical Excision,Cysts, Marsupialization false false false 0 0 1919 0 false 74631 18 B Surgical Excision,Cysts-1cm& Under Surgical Excision,Cysts1cm& Under false false false 0 0 false 74632 18 B Surgical Excision of Cyst 1-2cm Surgical Excision of Cyst 1-2cm false false false 0 0 false 74633 18 B Excision Of Cyst - 2-3 Cm Excision Of Cyst - 2-3 Cm false false false 0 0 1919 0 MODBLIV false 74634 18 B Excision Of Cyst - 3-4 Cm Excision Of Cyst - 3-4 Cm false false false 0 0 1919 0 MODBLIV false 74635 18 B Excision Of Cyst - 4-6 Cm Excision Of Cyst - 4-6 Cm false false false 0 0 1919 0 MODBLIV false 74636 18 B Excision Of Cyst - 6-9 Cm Excision Of Cyst - 6-9 Cm false false false 0 0 1919 0 MODBLIV false 74637 18 B Excision Of Cyst - 9-15 C Excision Of Cyst - 9-15 C false false false 0 0 1919 0 MODBLIV false 74638 18 B Excision Of Cyst - 15 Cm Excision Of Cyst - 15 Cm false false false 0 0 1919 0 MODBLIV false 75000 18 B Oral Hygiene Inst. Oral Hygiene Inst. false false false 0 0 1919 0 MODBLIV false 75010 18 B Tx Of Tmj Tx Of Tmj false false false 0 0 1919 0 MODBLIV false 75020 18 B Electrio-Myography Electrio-Myography false false false 0 0 1919 0 MODBLIV false 75030 18 B Electro Myography Subseq. Electro Myography Subseq. false false false 0 0 1919 0 MODBLIV false 75040 18 B T.E.N.S. T.E.N.S. false false false 0 0 1919 0 MODBLIV false 75050 18 B Mand Kinesiograph Ph 1-8) Mand Kinesiograph Ph 1-8) false false false 0 0 1919 0 MODBLIV false 75060 18 B Mand Kinesiograph Each Ph Mand Kinesiograph Each Ph false false false 0 0 1919 0 MODBLIV false 75070 18 B Non Specific Diag. Or Tx Non Specific Diag. Or Tx false false false 0 0 1919 0 MODBLIV false 75100 18 B Part/Mandibular/Plas W/Cl Part/Mandibular/Plas W/Cl false false false 0 0 1919 MODBLIV false 75111 18 B Surgical Incisions&Exploration, Intraoral,Soft Tissue Surgical Incisions&Exploration, Intraoral,Soft Tissue false false false 0 0 1919 0 false 75112 18 B Surgical Incisions,Intraoral, Abscess, Soft Tissue Surgical Incisions,Intraoral, Abscess, Soft Tissue false false false 0 0 1919 0 false 75113 18 B Incision/Drainage of Abscess Incision/Drainage of Abscess false true false 0 0 1919 0 false 75114 18 B Intraoral, Vestibular Or Intraoral, Vestibular Or false false false 0 0 1919 0 MODBLIV false 75115 18 B Intraoral, Superficial Intraoral, Superficial false false false 0 0 1919 0 MODBLIV false 75116 18 B Intraoral Deep Intraoral Deep false false false 0 0 1919 0 MODBLIV false 75121 18 B Surgical Incisions, Intraoral, Hard Tissue, Trephination& Drainage Surgical Incisions, Intraoral, Hard Tissue, Trephination& Drainage false false false 0 0 1919 0 false 75122 18 B Intraoral,Surgical Explor Intraoral,Surgical Explor false false false 0 0 1919 0 MODBLIV false 75123 18 B Intraoral,Abscess,Hard Ti Intraoral,Abscess,Hard Ti false false false 0 0 1919 MODBLIV false 75200 18 B Complete Maxillary Complete Maxillary false false false 0 0 1919 MODBLIV false 75211 18 B Surgical Incision,Extroral, Abscess,Superficial,Soft Tissue Surgical Incision,Extroral, Abscess,Superficial,Soft Tissue false false false 0 0 1919 0 false 75212 18 B Extraoral,Abscess,Deep Extraoral,Abscess,Deep false false false 0 0 1919 MODBLIV false 75221 18 B Surgical Incision-Extraor Surgical Incision-Extraor false false false 0 0 1919 MODBLIV false 75300 18 B Complete Mandibular Complete Mandibular false false false 0 0 1919 MODBLIV false 75301 18 B Surgical Incision for Removal from Skin/Subcutaneous Alveolar Tissue Surgical Incision for Removal from Skin/Subcutaneous Alveolar Tissue false false false 0 0 1919 0 false 75302 18 B Surgical Incision for Removal of Reaction-Producing Foreign Bodies Surgical Incision for Removal of Reaction-Producing Foreign Bodies false false false 0 0 1919 0 false 75303 18 B Removal Of Needle,Musculo Removal Of Needle,Musculo false false false 0 0 1919 MODBLIV false 75311 18 B Removal Of Foreign Bodie Removal Of Foreign Bodie false false false 0 0 1919 0 MODBLIV false 75313 18 B Removal Of Needle From B Removal Of Needle From B false false false 0 0 1919 0 MODBLIV false 75401 18 B Intraoral Sequestrectomy Intraoral Sequestrectomy false false false 0 0 1919 MODBLIV false 75402 18 B Saucerization Saucerization false false false 0 0 1919 MODBLIV false 75403 18 B Osteomyelitis,Non Surgica Osteomyelitis,Non Surgica false false false 0 0 1919 MODBLIV false 75404 18 B Sequestrectomy For Osteom Sequestrectomy For Osteom false false false 0 0 1919 0 MODBLIV false 75411 18 B Extraoral Sequestrectomy, Extraoral Sequestrectomy, false false false 0 0 1919 MODBLIV false 75412 18 B Sequestrectomy 3-4 Cm Sequestrectomy 3-4 Cm false false false 0 0 1919 MODBLIV false 75413 18 B Extraoral Sequestrectomy Extraoral Sequestrectomy false false false 0 0 1919 MODBLIV false 75414 18 B Extraoral Sequestrectomy Extraoral Sequestrectomy false false false 0 0 1919 MODBLIV false 75415 18 B Extraoral Sequestrectomy Extraoral Sequestrectomy false false false 0 0 1919 MODBLIV false 75421 18 B Augmentation Of The Chin Augmentation Of The Chin false false false 0 0 1919 MODBLIV false 75511 18 B Mandibulectomy -3 Cm Or L Mandibulectomy -3 Cm Or L false false false 0 0 1919 MODBLIV false 75512 18 B Mandibulectomy -3-4 Cm Mandibulectomy -3-4 Cm false false false 0 0 1919 MODBLIV false 75513 18 B Mandibulectomy -4-6 Cm Mandibulectomy -4-6 Cm false false false 0 0 1919 MODBLIV false 75514 18 B Mandibulectomy -6-9 Cm Mandibulectomy -6-9 Cm false false false 0 0 1919 MODBLIV false 75515 18 B Mandibulectomy -9-12 Cm Mandibulectomy -9-12 Cm false false false 0 0 1919 MODBLIV false 75516 18 B Mandibulectomy -12-15 Cm Mandibulectomy -12-15 Cm false false false 0 0 1919 MODBLIV false 75517 18 B Mandibulectomy -15 Cm And Mandibulectomy -15 Cm And false false false 0 0 1919 MODBLIV false 75518 18 B Total Mandibulectomy Total Mandibulectomy false false false 0 0 1919 MODBLIV false 75607 18 B Explor,Orb Frac W/Implant Explor,Orb Frac W/Implant false false false 0 0 1919 MODBLIV false 75611 18 B Maxillectomy -3 Cm Or Les Maxillectomy -3 Cm Or Les false false false 0 0 1919 MODBLIV false 75612 18 B Maxillectomy -3-4 Cm Maxillectomy -3-4 Cm false false false 0 0 1919 MODBLIV false 75613 18 B Maxillectomy -4-6 Cm Maxillectomy -4-6 Cm false false false 0 0 1919 MODBLIV false 75614 18 B Maxillectomy -6-9 Cm Maxillectomy -6-9 Cm false false false 0 0 1919 MODBLIV false 75615 18 B Maxillectomy -9-12 Cm Maxillectomy -9-12 Cm false false false 0 0 1919 MODBLIV false 75616 18 B Maxillectomy -12-15 Cm Maxillectomy -12-15 Cm false false false 0 0 1919 MODBLIV false 75617 18 B Maxillectomy -15 Cm And O Maxillectomy -15 Cm And O false false false 0 0 1919 MODBLIV false 75618 18 B Total Maxillectomy Total Maxillectomy false false false 0 0 1919 MODBLIV false 76111 18 B Wiring Of Dentures Or Arc Wiring Of Dentures Or Arc false false false 0 0 1919 0 MODBLIV false 76112 18 B Acrylic Prosthesis Or Cap Acrylic Prosthesis Or Cap false false false 0 0 1919 0 MODBLIV false 76113 18 B Circumzygomatic Wiring, U Circumzygomatic Wiring, U false false false 0 0 1919 0 MODBLIV false 76114 18 B Perialveolar Or Transpala Perialveolar Or Transpala false false false 0 0 1919 0 MODBLIV false 76115 18 B Intra Or Periosseous Spli Intra Or Periosseous Spli false false false 0 0 1919 0 MODBLIV false 76116 18 B Fractures,Treatment of Intermaillary Fixation(Wiring) SplintsPerArch,1orMorePerJaw Fractures,Treatment of Intermaillary Fixation(Wiring) SplintsPerArch,1orMorePerJaw false true false 0 3 0011 0 false 76121 18 B Nasal Spine Wiring Nasal Spine Wiring false false false 0 0 1919 0 MODBLIV false 76122 18 B Piriform Apertures Suspen Piriform Apertures Suspen false false false 0 0 1919 0 MODBLIV false 76123 18 B Frontal Suspension Frontal Suspension false false false 0 0 1919 0 MODBLIV false 76124 18 B Orbital Rim Suspension, B Orbital Rim Suspension, B false false false 0 0 1919 0 MODBLIV false 76125 18 B Head Frame Suspension Head Frame Suspension false false false 0 0 1919 0 MODBLIV false 76131 18 B Circummandibular Wiring - Circummandibular Wiring - false false false 0 0 1919 0 MODBLIV false 76132 18 B Circummandibular Wiring - Circummandibular Wiring - false false false 0 0 1919 0 MODBLIV false 76133 18 B Circummandibular Wiring - Circummandibular Wiring - false false false 0 0 1919 0 MODBLIV false 76141 18 B Fractures,Treatment of Splints/ Wires, Removal of Wire Fractures,Treatment of Splints/ Wires, Removal of Wire false true false 0 3 0012 0 false 76142 18 B Fractures,Treatment of Splints/ Wires, Removal of Arch Splint (1orMorePerJaw) Fractures,Treatment of Splints/ Wires, Removal of Arch Splint (1orMorePerJaw) false true false 0 3 0012 0 false 76143 18 B Removal Of Interosseous L Removal Of Interosseous L false false false 0 0 1919 0 MODBLIV false 76144 18 B Removal, Intra Or Perioss Removal, Intra Or Perioss false false false 0 0 1919 0 MODBLIV false 76145 18 B Removal, Acrylic Prosth./ Removal, Acrylic Prosth./ false false false 0 0 1919 0 MODBLIV false 76146 18 B Removal, Wire Plate/Screw Removal, Wire Plate/Screw false false false 0 0 1919 0 MODBLIV false 76201 18 B Fractures,Reductions, Mandibular, Closed Fractures,Reductions, Mandibular, Closed false true false 0 3 0022 0 false 76202 18 B Reduction, Mandibular, Op Reduction, Mandibular, Op false false false 0 0 1919 0 MODBLIV false 76203 18 B Reduction, Mandibular, Reduction, Mandibular, false false false 0 0 1919 0 MODBLIV false 76204 18 B Reduction, Mandibular, Reduction, Mandibular, false false false 0 0 1919 0 MODBLIV false 76301 18 B Fractures,Reductions,Alveolar, Debridement,Teeth Removed- 3cm or less Fractures,Reductions,Alveolar, Debridement,Teeth Removed- 3cm or less false true false 0 3 0011 0 false 76302 18 B Horizontal Le Forte1, Red Horizontal Le Forte1, Red false false false 0 0 1919 0 MODBLIV false 76303 18 B Horizontal Le Forte1, Red Horizontal Le Forte1, Red false false false 0 0 1919 0 MODBLIV false 76304 18 B Horizontal Le Forte1, Red Horizontal Le Forte1, Red false false false 0 0 1919 0 MODBLIV false 76305 18 B Horizontal Le Forte1, Red Horizontal Le Forte1, Red false false false 0 0 1919 MODBLIV false 76401 18 B Pyramidal Le Forte Ii, R Pyramidal Le Forte Ii, R false false false 0 0 1919 MODBLIV false 76402 18 B Pyramidal Le Forte Ii, R Pyramidal Le Forte Ii, R false false false 0 0 1919 MODBLIV false 76403 18 B Pyramidal Le Forte Ii, R Pyramidal Le Forte Ii, R false false false 0 0 1919 MODBLIV false 76501 18 B Reduction, Closed, Unila Reduction, Closed, Unila false false false 0 0 1919 MODBLIV false 76502 18 B Reduction, Closed, Bila Reduction, Closed, Bila false false false 0 0 1919 MODBLIV false 76503 18 B Reduction, Open, Externa Reduction, Open, Externa false false false 0 0 1919 MODBLIV false 76504 18 B Reduction, Open, Sinusal Reduction, Open, Sinusal false false false 0 0 1919 MODBLIV false 76505 18 B Reduction, Open, Orbital Reduction, Open, Orbital false false false 0 0 1919 MODBLIV false 76506 18 B Exploration, Of Orbital B Exploration, Of Orbital B false false false 0 0 1919 MODBLIV false 76507 18 B Exploration, Orbital Blow Exploration, Orbital Blow false false false 0 0 1919 MODBLIV false 76601 18 B Reduction, Malar Bone, Reduction, Malar Bone, false false false 0 0 1919 MODBLIV false 76602 18 B Reduction, Malar Bone, Reduction, Malar Bone, false false false 0 0 1919 MODBLIV false 76603 18 B Reduction, Malar Bone, Reduction, Malar Bone, false false false 0 0 1919 MODBLIV false 76604 18 B Reduction, Malar Bone, Reduction, Malar Bone, false false false 0 0 1919 MODBLIV false 76605 18 B Malar Bone, Simple Fract Malar Bone, Simple Fract false false false 0 0 1919 MODBLIV false 76701 18 B Reduction, Zygomatic Ar Reduction, Zygomatic Ar false false false 0 0 1919 MODBLIV false 76702 18 B Reduction, Zygomatic Ar Reduction, Zygomatic Ar false false false 0 0 1919 MODBLIV false 76703 18 B Zygomatico-Maxillary Fra Zygomatico-Maxillary Fra false false false 0 0 1919 MODBLIV false 76704 18 B Zygomatico-Maxillary Fra Zygomatico-Maxillary Fra false false false 0 0 1919 MODBLIV false 76801 18 B Reduction, Craniofacial Reduction, Craniofacial false false false 0 0 1919 MODBLIV false 76802 18 B Reduction, Craniofacial Reduction, Craniofacial false false false 0 0 1919 MODBLIV false 76911 18 B Fractures,Reductions,Alveolar, Debridement,Teeth Removed- 3cm or Less Fractures,Reductions,Alveolar, Debridement,Teeth Removed- 3cm or Less false false false 0 0 false 76912 18 B Fractures,Reductions,Alveolar,Debridement,Teeth Removed -3-6cm Fractures,Reductions,Alveolar,Debridement,Teeth Removed -3-6cm false false false 0 0 false 76913 18 B Fractures, Alveolar, Debr Fractures, Alveolar, Debr false false false 0 0 1919 0 MODBLIV false 76921 18 B Fracture,Alveolar,Closed, W/ Teeth,(fixation extra)-3cm or Less Fracture,Alveolar,Closed, W/ Teeth,(fixation extra)-3cm or Less false false false 0 0 1919 0 false 76922 18 B Fracture,Alveolar,Closed, W/ Teeth,(fixation extra)-3-6cm Fracture,Alveolar,Closed, W/ Teeth,(fixation extra)-3-6cm false false false 0 0 1919 0 false 76923 18 B Reduction, Alveolar, Clo Reduction, Alveolar, Clo false false false 0 0 1919 MODBLIV false 76924 18 B Reduction, Alveolar, Clo Reduction, Alveolar, Clo false false false 0 0 1919 MODBLIV false 76931 18 B Reduction,Alveolar,Open Reduction,Alveolar,Open false false false 0 0 1919 MODBLIV false 76932 18 B Reduction,Alveolar,Open Reduction,Alveolar,Open false false false 0 0 1919 MODBLIV false 76933 18 B Reduction, Alveolar, Ope Reduction, Alveolar, Ope false false false 0 0 1919 MODBLIV false 76934 18 B Reduction, Alveolar, Ope Reduction, Alveolar, Ope false false false 0 0 1919 MODBLIV false 76941 18 B Replantation,Avulsed Tooth/ Teeth(including splinting)-1st Tooth Replantation,Avulsed Tooth/ Teeth(including splinting)-1st Tooth false true false 0 0 1418 0 false 76949 18 B Replantation,Avulsed Tooth/ Teeth(including splinting)-Each Add Tooth Replantation,Avulsed Tooth/ Teeth(including splinting)-Each Add Tooth false true false 0 0 1418 0 false 76951 18 B Reposititoning of Traumatically Displaced Teeth-1 Unit of Time Reposititoning of Traumatically Displaced Teeth-1 Unit of Time false true false 0 0 1418 0 false 76952 18 B Reposititoning of Traumatically Displaced Teeth-2 Units of Time Reposititoning of Traumatically Displaced Teeth-2 Units of Time false true false 0 0 1418 0 false 76959 18 B Reposititoning of Traumatically Displaced Teeth-Each Add Unit over 2 Reposititoning of Traumatically Displaced Teeth-Each Add Unit over 2 false true false 0 0 1418 0 false 76961 18 B Repair,Laceration,Uncomplicated,Intraoral/Extraoral-2cm or Less Repair,Laceration,Uncomplicated,Intraoral/Extraoral-2cm or Less false false false 0 0 false 76962 18 B Repair,Laceration,Uncomplicated,Intraoral/Extraoral-2-4cm Repair,Laceration,Uncomplicated,Intraoral/Extraoral-2-4cm false false false 0 0 1919 0 false 76963 18 B Repair,Laceration,Uncomplicated,Intraoral/Extraoral-4-6cm Repair,Laceration,Uncomplicated,Intraoral/Extraoral-4-6cm false false false 0 0 1919 0 false 76964 18 B Repairs, Lacerations, Unc Repairs, Lacerations, Unc false false false 0 0 1919 MODBLIV false 76965 18 B Repairs, Lacerations, Unc Repairs, Lacerations, Unc false false false 0 0 1919 MODBLIV false 76966 18 B Repairs, Lacerations, Unc Repairs, Lacerations, Unc false false false 0 0 1919 MODBLIV false 76967 18 B Repairs, Lacerations, Unc Repairs, Lacerations, Unc false false false 0 0 1919 MODBLIV false 76968 18 B Repairs, Lacerations, Unc Repairs, Lacerations, Unc false false false 0 0 1919 MODBLIV false 76969 18 B Repairs, Lacerations, Unc Repairs, Lacerations, Unc false false false 0 0 1919 MODBLIV false 76971 18 B Repairs, Lacerations, Thr Repairs, Lacerations, Thr false false false 0 0 1919 MODBLIV false 76972 18 B Repairs, Lacerations, Thr Repairs, Lacerations, Thr false false false 0 0 1919 MODBLIV false 76973 18 B Repairs, Lacerations, Thr Repairs, Lacerations, Thr false false false 0 0 1919 MODBLIV false 76974 18 B Repairs, Lacerations, Thr Repairs, Lacerations, Thr false false false 0 0 1919 MODBLIV false 76975 18 B Repairs, Lacerations, Thr Repairs, Lacerations, Thr false false false 0 0 1919 MODBLIV false 76976 18 B Repairs, Lacerations, Thr Repairs, Lacerations, Thr false false false 0 0 1919 MODBLIV false 76977 18 B Repairs, Lacerations, Thr Repairs, Lacerations, Thr false false false 0 0 1919 MODBLIV false 76978 18 B Repairs, Lacerations, Thr Repairs, Lacerations, Thr false false false 0 0 1919 MODBLIV false 76979 18 B Repairs, Lacerations, Thr Repairs, Lacerations, Thr false false false 0 0 1919 MODBLIV false 76981 18 B Repairs, Lacerations, Com Repairs, Lacerations, Com false false false 0 0 1919 MODBLIV false 76982 18 B Repairs, Lacerations, Com Repairs, Lacerations, Com false false false 0 0 1919 MODBLIV false 76983 18 B Repairs, Lacerations, Com Repairs, Lacerations, Com false false false 0 0 1919 MODBLIV false 76984 18 B Repairs, Lacerations, Com Repairs, Lacerations, Com false false false 0 0 1919 MODBLIV false 76985 18 B Repairs, Lacerations, Com Repairs, Lacerations, Com false false false 0 0 1919 MODBLIV false 76986 18 B Repairs, Lacerations, Com Repairs, Lacerations, Com false false false 0 0 1919 MODBLIV false 76987 18 B Repairs, Lacerations, Com Repairs, Lacerations, Com false false false 0 0 1919 MODBLIV false 76988 18 B Repairs, Lacerations, Com Repairs, Lacerations, Com false false false 0 0 1919 MODBLIV false 76989 18 B Repairs, Lacerations, Com Repairs, Lacerations, Com false false false 0 0 1919 MODBLIV false 77101 18 B Osteotomy, Subcondylar, C Osteotomy, Subcondylar, C false false false 0 0 1919 MODBLIV false 77102 18 B Osteotomy, Subcondylar, O Osteotomy, Subcondylar, O false false false 0 0 1919 MODBLIV false 77103 18 B Osteotomy, Ramus Of The M Osteotomy, Ramus Of The M false false false 0 0 1919 MODBLIV false 77104 18 B Osteotomy, Ramus Of The M Osteotomy, Ramus Of The M false false false 0 0 1919 MODBLIV false 77105 18 B Osteotomy/Ostectomy, Body Osteotomy/Ostectomy, Body false false false 0 0 1919 MODBLIV false 77106 18 B Osteotomy, Coronoidectomy Osteotomy, Coronoidectomy false false false 0 0 1919 MODBLIV false 77107 18 B Osteotomy, Condylar Neck Osteotomy, Condylar Neck false false false 0 0 1919 MODBLIV false 77108 18 B Osteotomy, Sagittal Split Osteotomy, Sagittal Split false false false 0 0 1919 MODBLIV false 77201 18 B Osteotomy, Oblique With B Osteotomy, Oblique With B false false false 0 0 1919 MODBLIV false 77202 18 B Osteotomy, Inverted "l" Osteotomy, Inverted "l" false false false 0 0 1919 MODBLIV false 77203 18 B Osteotomy, "c" Osteotomy, "c" false false false 0 0 1919 MODBLIV false 77204 18 B Osteotomy of the Ramus of the Mandible for Distraction Osteogenesis - Unilateral Osteotomy of the Ramus of the Mandible for Distraction Osteogenesis - Unilateral false false false 0 0 false 0 77205 18 B Osteotomy of the Ramus of the Mandible for Distraction Osteogenesis - Bilateral Osteotomy of the Ramus of the Mandible for Distraction Osteogenesis - Unilateral false false false 0 0 false 0 77206 18 B Activation of Distraction Device - Unilateral Activation of Distraction Device - Unilateral false false false 0 0 false 0 77207 18 B Activation of Distraction Device - Bilateral Activation of Distraction Device - Bilateral false false false 0 0 false 0 77208 18 B Removal of Distraction Device - Unilateral Removal of Distraction Device - Unilateral false false false 0 0 false 0 77209 18 B Removal of Distraction Device - Bilateral Removal of Distraction Device - Bilateral false false false 0 0 false 0 77301 18 B Osteotomy, Maxilla, Lefor Osteotomy, Maxilla, Lefor false false false 0 0 1919 MODBLIV false 77302 18 B Osteotomy, Maxilla, Lefor Osteotomy, Maxilla, Lefor false false false 0 0 1919 MODBLIV false 77303 18 B Osteotomy, Maxilla, Lefor Osteotomy, Maxilla, Lefor false false false 0 0 1919 MODBLIV false 77304 18 B Additional Two Segments Additional Two Segments false false false 0 0 1919 MODBLIV false 77305 18 B Additional 3 Segments Additional 3 Segments false false false 0 0 1919 MODBLIV false 77306 18 B Additional 4 Segments Additional 4 Segments false false false 0 0 1919 MODBLIV false 77307 18 B Additional To The Above O Additional To The Above O false false false 0 0 1919 MODBLIV false 77308 18 B Closure Of Cleft Fistula Closure Of Cleft Fistula false false false 0 0 1919 MODBLIV false 77309 18 B Closure Of Cleft Fistula Closure Of Cleft Fistula false false false 0 0 1919 MODBLIV false 77311 18 B Pharyngoplasty Pharyngoplasty false false false 0 0 1919 MODBLIV false 77312 18 B Submucous Resection Submucous Resection false false false 0 0 1919 MODBLIV false 77313 18 B Osteotomy: Maxillary, LeFort 1 false false false 0 0 false 0 77314 18 B Osteotomy: Maxillary, LeFort 2 false false false 0 0 false 0 77315 18 B Osteogenesis: Maxillary, LeFort 3 false false false 0 0 false 0 77316 18 B Activation of Distraction Device, LeFort 1 false false false 0 0 false 0 77317 18 B Activation of Distraction Device, LeFort 2 false false false 0 0 false 0 77318 18 B Activation of Distraction Device, LeFort 3 false false false 0 0 false 0 77319 18 B Removal of Maxillary Distraction Device false false false 0 0 false 0 77411 18 B Segmental, Maxilla, Ant Segmental, Maxilla, Ant false false false 0 0 1919 MODBLIV false 77412 18 B Segmental, Maxilla, Po Segmental, Maxilla, Po false false false 0 0 1919 MODBLIV false 77413 18 B Midpalatal Split, Maxil Midpalatal Split, Maxil false false false 0 0 1919 MODBLIV false 77414 18 B Midpalatal Split, Maxil Midpalatal Split, Maxil false false false 0 0 1919 MODBLIV false 77415 18 B Osteotomy: Segmental, Anterior false false false 0 0 false 0 77416 18 B Osteotomy: Segmental, Posterior false false false 0 0 false 0 77417 18 B Activation of Distraction Device false false false 0 0 false 0 77418 18 B Removal of Segmentation Maxillary Distraction Device false false false 0 0 false 0 77421 18 B Segmental, Mandible, Ant Segmental, Mandible, Ant false false false 0 0 1919 MODBLIV false 77422 18 B Segmental, Mandible,Ant Segmental, Mandible,Ant false false false 0 0 1919 MODBLIV false 77423 18 B Segmental, Posterior Segmental, Posterior false false false 0 0 1919 MODBLIV false 77424 18 B Lower Border, Mandible Lower Border, Mandible false false false 0 0 1919 MODBLIV false 77425 18 B Total Dento-Alveolar, Ma Total Dento-Alveolar, Ma false false false 0 0 1919 MODBLIV false 77426 18 B Osteotomy: Segmental, Anterior false false false 0 0 false 0 77427 18 B Osteotomy: Segmental, Posterior false false false 0 0 false 0 77428 18 B Activation of Distraction Device false false false 0 0 false 0 77429 18 B Removal of Segmental Mandibular Distraction Device false false false 0 0 false 0 77431 18 B 'interpositional Graft' 'interpositional Graft' false false false 0 0 1919 MODBLIV false 77432 18 B 'interpositional Graft' 'interpositional Graft' false false false 0 0 1919 MODBLIV false 77433 18 B 'interpositional Graft' 'interpositional Graft' false false false 0 0 1919 MODBLIV false 77441 18 B 'onlay Graft' - Using Bo 'onlay Graft' - Using Bo false false false 0 0 1919 MODBLIV false 77442 18 B 'onlay Graft' -Using All 'onlay Graft' -Using All false false false 0 0 1919 MODBLIV false 77443 18 B 'onlay Graft' -Using Car 'onlay Graft' -Using Car false false false 0 0 1919 MODBLIV false 77501 18 B Sliding, Reduction Or Aug Sliding, Reduction Or Aug false false false 0 0 1919 MODBLIV false 77502 18 B Reduction (vertical) Reduction (vertical) false false false 0 0 1919 MODBLIV false 77503 18 B Augmentation With Graft ( Augmentation With Graft ( false false false 0 0 1919 MODBLIV false 77504 18 B Myotomy, Suprahyoid Myotomy, Suprahyoid false false false 0 0 1919 MODBLIV false 77601 18 B Corticotomy Corticotomy false false false 0 0 1919 MODBLIV false 77602 18 B Interdental Septotomy Interdental Septotomy false false false 0 0 1919 MODBLIV false 77603 18 B Surgical Expansion Of The Surgical Expansion Of The false false false 0 0 1919 MODBLIV false 77604 18 B Surgical Expansion of Alveolar Ridge - Maxilla false false false 0 0 false 0 77605 18 B Surgical expansion of alveolar ridge - Mandible false false false 0 0 false 0 77701 18 B Palatorrhaphy, Anterior ( Palatorrhaphy, Anterior ( false false false 0 0 1919 MODBLIV false 77702 18 B Palatorrhaphy, Posterior Palatorrhaphy, Posterior false false false 0 0 1919 MODBLIV false 77703 18 B Palatorrhaphy, Total Palatorrhaphy, Total false false false 0 0 1919 MODBLIV false 77704 18 B Palatorrhaphy, With Bone Palatorrhaphy, With Bone false false false 0 0 1919 MODBLIV false 77705 18 B Palatorrhaphy, Bone Graft Palatorrhaphy, Bone Graft false false false 0 0 1919 MODBLIV false 77777 18 B false false false 0 0 1919 0 MODBLIV 0 false 0 77801 18 B Maxillofacial Deformaties Frenectomy/Frenoplasty- Upper Labial Maxillofacial Deformaties Frenectomy/Frenoplasty- Upper Labial false true false 0 3 0011 0 false 77802 18 B Maxillofacial Deformaties Frenectomy/Frenoplasty- Lower Labial Maxillofacial Deformaties Frenectomy/Frenoplasty- Lower Labial false true false 0 3 0011 0 false 77803 18 B Maxillofacial Deformaties Frenectomy/Frenoplasty- Upper Lingual/ "Z" Plasty Maxillofacial Deformaties Frenectomy/Frenoplasty- Upper Lingual/ "Z" Plasty false true false 0 3 0011 0 false 77804 18 B Maxillofacial Deformaties Frenectomy/Frenoplasty- Upper Lingual/ "Z" Plasty W/ Myotomy of Genioglossus Maxillofacial Deformaties Frenectomy/Frenoplasty- Upper Lingual/ "Z" Plasty W/ Myotomy of Genioglossus false true false 0 3 0011 0 false 77805 18 B Frenoplasty, Upper "z" Frenoplasty, Upper "z" false false false 0 0 1919 MODBLIV false 77806 18 B Frenoplasty, Lower "z" Frenoplasty, Lower "z" false false false 0 0 1919 MODBLIV false 77901 18 B Glossectomy, Partial, Ant Glossectomy, Partial, Ant false false false 0 0 1919 MODBLIV false 77902 18 B Glossectomy, Partial, For Glossectomy, Partial, For false false false 0 0 1919 MODBLIV false 77903 18 B Glossectomy, Full Postero Glossectomy, Full Postero false false false 0 0 1919 MODBLIV false 77911 18 B Primary Unilateral Cleft Primary Unilateral Cleft false false false 0 0 1919 MODBLIV false 77912 18 B Secondary Unilateral Clef Secondary Unilateral Clef false false false 0 0 1919 MODBLIV false 77913 18 B Primary Bilateral Cleft L Primary Bilateral Cleft L false false false 0 0 1919 MODBLIV false 77914 18 B Secondary Bilateral Cleft Secondary Bilateral Cleft false false false 0 0 1919 MODBLIV false 77915 18 B Reconstruction Of Cleft L Reconstruction Of Cleft L false false false 0 0 1919 MODBLIV false 77916 18 B Complex Reconstruction Or Complex Reconstruction Or false false false 0 0 1919 MODBLIV false 77917 18 B Closure Of Alveolar Cleft Closure Of Alveolar Cleft false false false 0 0 1919 MODBLIV false 77921 18 B Primary Closure At Time O Primary Closure At Time O false false false 0 0 1919 MODBLIV false 77922 18 B Secondary Closure With Pa Secondary Closure With Pa false false false 0 0 1919 MODBLIV false 77923 18 B Secondary Closure With Ph Secondary Closure With Ph false false false 0 0 1919 MODBLIV false 77924 18 B Secondary Closure With To Secondary Closure With To false false false 0 0 1919 MODBLIV false 77925 18 B Secondary Closure With Bu Secondary Closure With Bu false false false 0 0 1919 MODBLIV false 77931 18 B Rigid Internal Fixation Rigid Internal Fixation false false false 0 0 1919 MODBLIV false 77932 18 B Rigid Internal Fixation U Rigid Internal Fixation U false false false 0 0 1919 MODBLIV false 77933 18 B Rigid Internal Fixation U Rigid Internal Fixation U false false false 0 0 1919 MODBLIV false 77934 18 B Rigid Internal Fixation U Rigid Internal Fixation U false false false 0 0 1919 MODBLIV false 78101 18 B Tmj, Dislocation, Open Re Tmj, Dislocation, Open Re false false false 0 0 1919 MODBLIV false 78102 18 B TMJ,Dislocation,Closed Reduction,Uncomplicated TMJ,Dislocation,Closed Reduction,Uncomplicated false true false 0 3 0022 0 false 78103 18 B Tmj, Dislocation, Closed Tmj, Dislocation, Closed false false false 0 0 1919 MODBLIV false 78104 18 B TMJ,Luxation,Reducation Without Anesthesia TMJ,Luxation,Reducation Without Anesthesia false true false 0 3 0022 0 false 78105 18 B Tmj, Luxation, Reduction Tmj, Luxation, Reduction false false false 0 0 1919 MODBLIV false 78106 18 B Tmj, Manipulation, Under Tmj, Manipulation, Under false false false 0 0 1919 0 MODBLIV false 78107 18 B Tmj,Fixation Tmj,Fixation false false false 0 0 1919 MODBLIV false 78201 18 B Tmj, Arthrotomy, Condylop Tmj, Arthrotomy, Condylop false false false 0 0 1919 MODBLIV false 78202 18 B Tmj, Arthrotomy, Condylot Tmj, Arthrotomy, Condylot false false false 0 0 1919 MODBLIV false 78203 18 B Tmj, Arthrotomy, Condylec Tmj, Arthrotomy, Condylec false false false 0 0 1919 MODBLIV false 78204 18 B Tmj, Arthrotomy, Eminopla Tmj, Arthrotomy, Eminopla false false false 0 0 1919 MODBLIV false 78205 18 B Tmj, Arthrotomy, Re-Conto Tmj, Arthrotomy, Re-Conto false false false 0 0 1919 MODBLIV false 78206 18 B Tmj, Arthrotomy, Menisect Tmj, Arthrotomy, Menisect false false false 0 0 1919 MODBLIV false 78207 18 B Tmj, Arthrotomy, Plicatio Tmj, Arthrotomy, Plicatio false false false 0 0 1919 MODBLIV false 78208 18 B Tmj, Arthrotomy, Repair O Tmj, Arthrotomy, Repair O false false false 0 0 1919 MODBLIV false 78209 18 B Tmj, Arthrotomy, Replacem Tmj, Arthrotomy, Replacem false false false 0 0 1919 MODBLIV false 78301 18 B Tmj, Arthrotomy, Major Re Tmj, Arthrotomy, Major Re false false false 0 0 1919 MODBLIV false 78302 18 B Tmj, Arthrotomy, Major Re Tmj, Arthrotomy, Major Re false false false 0 0 1919 MODBLIV false 78303 18 B Tmj, Arthrotomy, Major Re Tmj, Arthrotomy, Major Re false false false 0 0 1919 MODBLIV false 78401 18 B Tmj Arthroscopic Examinat Tmj Arthroscopic Examinat false false false 0 0 1919 MODBLIV false 78402 18 B Tmj, Arthroscopy, Biopsy Tmj, Arthroscopy, Biopsy false false false 0 0 1919 MODBLIV false 78403 18 B Tmj, Arthroscopy,Removal Tmj, Arthroscopy,Removal false false false 0 0 1919 MODBLIV false 78404 18 B Tmj, Arthroscopy,Lavage Tmj, Arthroscopy,Lavage false false false 0 0 1919 MODBLIV false 78405 18 B Tmj, Arthroscopy,Lysis Of Tmj, Arthroscopy,Lysis Of false false false 0 0 1919 MODBLIV false 78406 18 B Tmj, Arthroscopy,Synovect Tmj, Arthroscopy,Synovect false false false 0 0 1919 MODBLIV false 78407 18 B Tmj, Arthroscopy,Condylop Tmj, Arthroscopy,Condylop false false false 0 0 1919 MODBLIV false 78408 18 B Tmj, Arthroscopy,Eminopla Tmj, Arthroscopy,Eminopla false false false 0 0 1919 MODBLIV false 78409 18 B Tmj, Arthroscopy,Re-Conto Tmj, Arthroscopy,Re-Conto false false false 0 0 1919 MODBLIV false 78411 18 B Tmj, Arthroscopy,Menisect Tmj, Arthroscopy,Menisect false false false 0 0 1919 MODBLIV false 78412 18 B Tmj, Arthroscopy,Plicatio Tmj, Arthroscopy,Plicatio false false false 0 0 1919 MODBLIV false 78413 18 B Tmj, Arthroscopy,Repair O Tmj, Arthroscopy,Repair O false false false 0 0 1919 MODBLIV false 78501 18 B Arthrocentesis, One Unit Arthrocentesis, One Unit false false false 0 0 1919 MODBLIV false 78502 18 B Arthrocentesis, 2 Units Arthrocentesis, 2 Units false false false 0 0 1919 MODBLIV false 78509 18 B Arthrocentesis, +2units Arthrocentesis, +2units false false false 0 0 1919 MODBLIV false 78601 18 B TMJ,Injection W/Anti-Inflmmatory Drugs TMJ,Injection W/Anti-Inflmmatory Drugs false true false 0 3 0022 0 false 78602 18 B Tmj, Injection, With Scle Tmj, Injection, With Scle false false false 0 0 1919 MODBLIV false 78701 18 B Tmj, Appliance Splint, Ma Tmj, Appliance Splint, Ma false false false 0 0 1919 MODBLIV false 78702 18 B Tmj, Appliance Splint, Ma Tmj, Appliance Splint, Ma false false false 0 0 1919 MODBLIV false 78801 18 B Perform Arthrographic Pro Perform Arthrographic Pro false false false 0 0 1919 MODBLIV false 78802 18 B Interpret Arthrogram Interpret Arthrogram false false false 0 0 1919 MODBLIV false 79101 18 B Dilation of Salivary Duct Dilation of Salivary Duct false false false 0 0 false 79102 18 B Salivary Duct, Insertion Salivary Duct, Insertion false false false 0 0 1919 MODBLIV false 79103 18 B Salivary Duct, Sialodocho Salivary Duct, Sialodocho false false false 0 0 1919 MODBLIV false 79104 18 B Salivary Duct, Reconstruc Salivary Duct, Reconstruc false false false 0 0 1919 MODBLIV false 79111 18 B Salivary Duct,Sialolithotomy-Anterior 1/3 of Canal Salivary Duct,Sialolithotomy-Anterior 1/3 of Canal false true false 0 0 1413 0 false 79112 18 B Sialolithotomy, Posterior Sialolithotomy, Posterior false false false 0 0 1919 MODBLIV false 79113 18 B Sialolithotomy, External Sialolithotomy, External false false false 0 0 1919 MODBLIV false 79121 18 B Excision Of Submaxillary Excision Of Submaxillary false false false 0 0 1919 MODBLIV false 79122 18 B Excision Of Sublingual Gl Excision Of Sublingual Gl false false false 0 0 1919 MODBLIV false 79123 18 B Excision Of Mucocele Excision Of Mucocele false false false 0 0 1919 MODBLIV false 79124 18 B Excision Of Ranula Excision Of Ranula false false false 0 0 1919 MODBLIV false 79125 18 B Marsupialization Of Ranul Marsupialization Of Ranul false false false 0 0 1919 MODBLIV false 79131 18 B Salivary Gland, Removal, Salivary Gland, Removal, false false false 0 0 1919 MODBLIV false 79132 18 B Salivary Gland, Removal, Salivary Gland, Removal, false false false 0 0 1919 MODBLIV false 79211 18 B Trigeminal Nerve, Injecti Trigeminal Nerve, Injecti false false false 0 0 1919 MODBLIV false 79212 18 B Trigeminal Nerve, Avulsio Trigeminal Nerve, Avulsio false false false 0 0 1919 MODBLIV false 79213 18 B Trigeminal Nerve, Total A Trigeminal Nerve, Total A false false false 0 0 1919 MODBLIV false 79214 18 B Trigeminal Nerve, Alcohol Trigeminal Nerve, Alcohol false false false 0 0 1919 MODBLIV false 79215 18 B Trigeminal Nerve, Infiltr Trigeminal Nerve, Infiltr false false false 0 0 1919 MODBLIV false 79216 18 B Trig Nerve,Intraoperative Trig Nerve,Intraoperative false false false 0 0 1919 MODBLIV false 79217 18 B Trig Nerve,Neurolysis,Bon Trig Nerve,Neurolysis,Bon false false false 0 0 1919 MODBLIV false 79218 18 B Trig Nerve,Neurolysis,Sof Trig Nerve,Neurolysis,Sof false false false 0 0 1919 MODBLIV false 79221 18 B Mental Nerve, Transportat Mental Nerve, Transportat false false false 0 0 1919 MODBLIV false 79222 18 B Mental Nerve, Decompressi Mental Nerve, Decompressi false false false 0 0 1919 MODBLIV false 79231 18 B Inferior Dental Nerve, Co Inferior Dental Nerve, Co false false false 0 0 1919 MODBLIV false 79232 18 B Inferior Dent Nerve,Decom Inferior Dent Nerve,Decom false false false 0 0 1919 MODBLIV false 79241 18 B Injured Nerve Repair,Prim Injured Nerve Repair,Prim false false false 0 0 1919 MODBLIV false 79242 18 B Injured Nerve Repair,Sec Injured Nerve Repair,Sec false false false 0 0 1919 MODBLIV false 79243 18 B Injured Nerve Repair,Sec. Injured Nerve Repair,Sec. false false false 0 0 1919 MODBLIV false 79244 18 B Neural Trans & Decompres Neural Trans & Decompres false false false 0 0 1919 MODBLIV false 79245 18 B Implant Electrode Implant Electrode false false false 0 0 1919 MODBLIV false 79246 18 B Excision Of Tumour Excision Of Tumour false false false 0 0 1919 MODBLIV false 79247 18 B Nerve Repair W/Graft Nerve Repair W/Graft false false false 0 0 1919 MODBLIV false 79248 18 B Harvest Nerve Graft Harvest Nerve Graft false false false 0 0 1919 MODBLIV false 79251 18 B Epineural Suture Epineural Suture false false false 0 0 1919 MODBLIV false 79252 18 B Fascicular Suture Fascicular Suture false false false 0 0 1919 MODBLIV false 79253 18 B Conduit Implant Up To 3cm Conduit Implant Up To 3cm false false false 0 0 1919 MODBLIV false 79254 18 B Conduit Implant +3cm Conduit Implant +3cm false false false 0 0 1919 MODBLIV false 79255 18 B Fibrin Adhesive Fibrin Adhesive false false false 0 0 1919 MODBLIV false 79256 18 B Laser Coagulation Laser Coagulation false false false 0 0 1919 MODBLIV false 79258 18 B Operating Microscopes Operating Microscopes false false false 0 0 1919 MODBLIV false 79311 18 B Immediate Recovery of a Dental Root/Foreign Body from Antrum Immediate Recovery of a Dental Root/Foreign Body from Antrum false false false 0 0 false 79312 18 B Antral Surg-Immed. Closur Antral Surg-Immed. Closur false false false 0 0 1919 0 MODBLIV false 79313 18 B Delayed Recovery Of A De Delayed Recovery Of A De false false false 0 0 1919 0 MODBLIV false 79314 18 B Antral Surgery With Nasal Antral Surgery With Nasal false false false 0 0 1919 MODBLIV false 79321 18 B Oral Approach Lavage Oral Approach Lavage false false false 0 0 1919 0 MODBLIV false 79322 18 B Nasal Approach Lavage Nasal Approach Lavage false false false 0 0 1919 0 MODBLIV false 79331 18 B Antral Surgery,Oro-Antral Fistula Closure W/Buccal Flap (same session) Antral Surgery,Oro-Antral Fistula Closure W/Buccal Flap (same session) false false false 0 0 false 79332 18 B Closure Ora-Antral Fistul Closure Ora-Antral Fistul false false false 0 0 1919 0 MODBLIV false 79333 18 B Antral Surgery,Oro-Antral Fistula Closure W/Palatal Flap (same session) Antral Surgery,Oro-Antral Fistula Closure W/Palatal Flap (same session) false false false 0 0 1919 0 false 79341 18 B Antral Surgery,Oro-Antral Fistula Closure W/Bucal Flap (subsequent session) Antral Surgery,Oro-Antral Fistula Closure W/Bucal Flap (subsequent session) false false false 0 0 false 79342 18 B Antral Surgery Antral Surgery false false false 0 0 1919 0 MODBLIV false 79343 18 B Antral Surgery,Oro-Antral Fistula Closure W/Palatal Flap (subsequent session) Antral Surgery,Oro-Antral Fistula Closure W/Palatal Flap (subsequent session) false false false 0 0 false 79351 18 B Sinus Osseous Augmentation - Autograft false false false 0 0 false 0 79352 18 B Sinus Osseous Augmentation - Allograft false false false 0 0 false 0 79353 18 B Sinus Osseous Augmentation - Xenograft false false false 0 0 false 0 79354 18 B Sinus Osseous Augmentation - Indirect Autograft false false false 0 0 false 0 79355 18 B Sinus Osseous Augmentation - Indirect Allograft false false false 0 0 false 0 79356 18 B Sinus Osseous Augmentation - Indirect Xenograft false false false 0 0 false 0 79401 18 B Primary Hemorrhage, Contr Primary Hemorrhage, Contr false false false 0 0 1919 MODBLIV false 79402 18 B Secondary Hemorrhage Cont Secondary Hemorrhage Cont false false false 0 0 1919 0 MODBLIV false 79403 18 B Hemorrhage Control,Compre Hemorrhage Control,Compre false false false 0 0 1919 0 MODBLIV false 79404 18 B Hemorrhage Control,Hemost Hemorrhage Control,Hemost false false false 0 0 1919 0 MODBLIV false 79511 18 B Intraoral Tissue For Gra Intraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79512 18 B Intraoral Tissue For Gra Intraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79513 18 B Intraoral Tissue For Gra Intraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79514 18 B Intraoral Tissue For Gra Intraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79515 18 B Intraoral Tissue For Gra Intraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79516 18 B Intraoral Tissue For Gra Intraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79517 18 B Intraoral Tissue For Gra Intraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79521 18 B Extraoral Tissue For Gra Extraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79522 18 B Extraoral Tissue For Gra Extraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79523 18 B Extraoral Tissue For Gra Extraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79524 18 B Extraoral Tissue For Gra Extraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79525 18 B Extraoral Tissue For Gra Extraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79526 18 B Extraoral Tissue For Gra Extraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79527 18 B Extraoral Tissue For Gra Extraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79528 18 B Extraoral Tissue For Gra Extraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79529 18 B Extraoral Tissue For Gra Extraoral Tissue For Gra false false false 0 0 1919 MODBLIV false 79531 18 B Vasc. Tis. Flaps/Free Vasc. Tis. Flaps/Free false false false 0 0 1919 MODBLIV false 79532 18 B Vasc. Tis. Flaps/Attached Vasc. Tis. Flaps/Attached false false false 0 0 1919 MODBLIV false 79541 18 B Harvesting and Preparation of Platelet Rich Plasma false false false 0 0 false 0 79551 18 B Delivery of Growth Factors - Autologous - per site + E false false false 0 0 false 0 79552 18 B Deilvery of Growth Factors - Allogenic - per site + E Deilvery of Growth Factors - Allogenic - per site + E false false false 0 0 false 0 79553 18 B Deilvery of Growth Factors - Human Recombinant - per site + E Deilvery of Growth Factors - Human Recombinant - per site + E false false false 0 0 false 0 79601 18 B Subsequent to Initial Post Surgical Treatment,Minor,by Treating Dentist Subsequent to Initial Post Surgical Treatment,Minor,by Treating Dentist false false false 0 0 false 79602 18 B Subsequent to Initial Post Surgical Treatment,Minor,by Other than Treating Dentist Subsequent to Initial Post Surgical Treatment,Minor,by Other than Treating Dentist false false false 0 0 false 79603 18 B Post Surgical Care,Major Post Surgical Care,Major false false false 0 0 1919 0 MODBLIV false 79604 18 B Post Surgical Care,Major Post Surgical Care,Major false false false 0 0 1919 0 MODBLIV false 79605 18 B Post-Surgical Care,Alveolitis, Treament of(without anesthesia) Post-Surgical Care,Alveolitis, Treament of(without anesthesia) false false false 0 0 false 79606 18 B Post-Surgical Care,Alveolitis, Treament of(with anesthesia) Post-Surgical Care,Alveolitis, Treament of(with anesthesia) false false false 0 0 false 79701 18 B Emergency Tracheotomy Emergency Tracheotomy false false false 0 0 1919 MODBLIV false 79702 18 B Emergency Crico-Thyroidot Emergency Crico-Thyroidot false false false 0 0 1919 MODBLIV false 79801 18 B Treatment Of Musc. Dysfun Treatment Of Musc. Dysfun false false false 0 0 1919 MODBLIV false 79802 18 B Musc. Disorders/Myotomy Musc. Disorders/Myotomy false false false 0 0 1919 MODBLIV false 79911 22 B Implant,Blade-Maxillary per Implant Implant,Blade-Maxillary per Implant true true false 0 3 0011 0 false 79912 22 B Implant,Blade-Mandibular per Implant Implant,Blade-Mandibular per Implant true true false 0 3 0022 0 false 79920 22 B Implants, Subperiosteal Implants, Subperiosteal false false false 0 0 false 0 79921 22 B Implants,Mucosal Insert Implant Denture-Maxillary Implants,Mucosal Insert Implant Denture-Maxillary true true false 0 3 0011 0 false 79922 22 B Implants,Mucosal Insert Implant Denture-Mandibular Implants,Mucosal Insert Implant Denture-Mandibular true false false 0 0 false 79930 22 B Implants, Ossenointegrated, Root Form, More Implants, Ossenointegrated, Root Form, More false false false 0 0 false 0 79931 18 B Screw And Tripodal Pin Or Screw And Tripodal Pin Or false false false 0 0 1919 MODBLIV false 79932 18 B Screw And Tripodal Pin Or Screw And Tripodal Pin Or false false false 0 0 1919 MODBLIV false 79933 18 B Surgical Installation of Implant with Final Transmucusal Element - per Implant + E Surgical Installation of Implant with Final Transmucusal Element - per Implant + E false false false 0 0 false 0 79934 18 B Surgical Re-entry, Removal of Healing Screw and Placement of Healing Transmucosal Element - per Implant + E Surgical Re-entry, Removal of Healing Screw and Placement of Healing Transmucosal Element - per Implant + E false false false 0 0 false 0 79935 18 B Surgical Re-entry, Removal of Healing Screw and Placement of Final Standard Transmucosal Element - per Implant + E Surgical Re-entry, Removal of Healing Screw and Placement of Final Standard Transmucosal Element - per Implant + E false false false 0 0 false 0 79936 18 B Surgical Re-entry, Removal of Healing Screw and Placement of Final Custom Transmucosal Element - per Implant + E Surgical Re-entry, Removal of Healing Screw and Placement of Final Custom Transmucosal Element - per Implant + E true false false 0 0 false 0 79940 18 B Implants Osseointegrated, Root Form, Single Component Implants Osseointegrated, Root Form, Single Component false false false 0 0 false 0 79941 22 B Implants,Supperiosteal-Maxillary Implants,Supperiosteal-Maxillary true true false 0 3 0011 0 false 79942 22 B Implants,Supperiosteal-Mandibular Implants,Supperiosteal-Mandibular true true false 0 3 0022 0 false 79950 18 B Implants, Osseointegrated, Provisional Implants, Osseointegrated, Provisional false false false 0 0 false 0 79951 22 B Implant,Endosseous,Intergrated Cylindrical-1st Stage Sugical Placement-Maxilla per Implant Implant,Endosseous,Intergrated Cylindrical-1st Stage Sugical Placement-Maxilla per Implant true true false 0 3 0011 0 false 79952 22 B Implant,Endosseous,Intergrated Cylindrical-1st Stage Sugical Placement-Mandible per Implant Implant,Endosseous,Intergrated Cylindrical-1st Stage Sugical Placement-Mandible per Implant true true false 0 3 0022 0 false 79953 22 B Implant,Endosseous,Intergrated Cylindrical-2nd Stage Exposure& Temporization Maxilia per Implant Implant,Endosseous,Intergrated Cylindrical-2nd Stage Exposure& Temporization Maxilia per Implant true true false 0 3 0011 0 false 79954 22 B Implant,Endosseous,Intergrated Cylindrical-2nd Stage Exposure& Temporization Mandible per Implant Implant,Endosseous,Intergrated Cylindrical-2nd Stage Exposure& Temporization Mandible per Implant true true false 0 3 0022 0 false 79960 18 B Implants, Removal of Implants, Removal of false false false 0 0 false 0 79961 18 B Per implant, Uncomplicated Per implant, Uncomplicated false false false 0 0 false 0 79962 18 B Per implant, Complicated Per implant, Complicated false false false 0 0 false 0 79991 22 B Implant,Removal of Uncomplicated,per Implant Implant,Removal of Uncomplicated,per Implant false true false 0 0 1418 0 false 79992 22 B Implant,Removal of Complicated,per Implant Implant,Removal of Complicated,per Implant false true false 0 0 1418 0 false 80000 19 O false false false 0 0 1919 0 MODBLIV 0 false 0 80001 19 O Ortho Exam Ortho Exam false false false 0 0 false 80002 19 O Treatment Plan Treatment Plan false false false 0 0 false 0 80601 19 O Ortho Observation-for Tooth Guidence Ortho Observation-for Tooth Guidence false false false 0 0 false 80602 19 O Ortho Oberservation& Adjustment-to Ortho Appliance/ the Reduction of Poximal Surfaces of Teeth Per Appt Ortho Oberservation& Adjustment-to Ortho Appliance/ the Reduction of Poximal Surfaces of Teeth Per Appt false false false 0 0 false 80631 19 O Repairs to Removable/Fixed Appliances-1 Unit of Time Repairs to Removable/Fixed Appliances-1 Unit of Time true false false 0 0 false 80632 19 O Repairs to Removable/Fixed Appliances-2 Units of Time Repairs to Removable/Fixed Appliances-2 Units of Time true false false 0 0 false 80639 19 O Repairs to Removable/Fixed Appliances-Each Add Unit over 2 Repairs to Removable/Fixed Appliances-Each Add Unit over 2 true false false 0 0 false 80641 19 O Alteratins to Removable/Fixed Appliances-1 Unit of Time Alteratins to Removable/Fixed Appliances-1 Unit of Time true false false 0 0 false 80642 19 O Alteratins to Removable/Fixed Appliances-2 Units of Time Alteratins to Removable/Fixed Appliances-2 Units of Time true false false 0 0 false 80649 19 O Alteratins to Removable/Fixed Appliances-Each Add Unit over 2 Alteratins to Removable/Fixed Appliances-Each Add Unit over 2 true false false 0 0 false 80651 19 O Recmentaion of Fixed Appliances-1 Unit of Time Recmentaion of Fixed Appliances-1 Unit of Time false false false 0 0 false 80659 19 O Recmentaion of Fixed Appliances-Each Add Unit Recmentaion of Fixed Appliances-Each Add Unit false false false 0 0 false 80661 19 O Separation-1 Unit of Time Separation-1 Unit of Time false false false 0 0 false 80669 19 O Separation-Each Add Unit Separation-Each Add Unit false false false 0 0 false 80671 19 O Removal of Fixed Ortho Appliances(by a different practioner)-1 Unit of Time Removal of Fixed Ortho Appliances(by a different practioner)-1 Unit of Time false false false 0 0 false 80672 19 O Remov Appl. 2 Units Remov Appl. 2 Units false false false 0 0 1919 MODBLIV false 80679 19 O Removal of Fixed Ortho Appliances(by a different practioner)-Each Add Unit Removal of Fixed Ortho Appliances(by a different practioner)-Each Add Unit false false false 0 0 false 81111 19 O Ortho Treatment Plan-Monthly Fees Ortho Treatment Plan-Monthly Fees false false false 0 0 false 81112 19 O Space Regaining - Mandibu Space Regaining - Mandibu false false false 0 0 1919 0 MODBLIV false 81113 19 O Appliances,Removable,Space Regaining-Maxillary,Bilateral Appliances,Removable,Space Regaining-Maxillary,Bilateral true true false 0 3 0011 0 false 81114 19 O Appliances,Removable,Space Regaining-Mandibular,Bilateral Appliances,Removable,Space Regaining-Mandibular,Bilateral true true false 0 3 0022 0 false 81115 19 O Appliances,Removable,Space Regaining-Maxillary,Complex Appliances,Removable,Space Regaining-Maxillary,Complex true true false 0 3 0011 0 false 81116 19 O Appliances,Removable,Space Regaining-Mandibular,Complex Appliances,Removable,Space Regaining-Mandibular,Complex true true false 0 3 0022 0 false 81121 19 O Appliances,Removable,Cross- Bite Correction-Maxillary,Simple Appliances,Removable,Cross- Bite Correction-Maxillary,Simple true true false 0 3 0011 0 false 81122 19 O Appliances,Removable,Cross- Bite Correction Mandibular, Simple Appliances,Removable,Cross- Bite Correction Mandibular, Simple true true false 0 3 0022 0 false 81123 19 O Appliances,Removable,Cross- Bite Correction Maxillary, Complex Appliances,Removable,Cross- Bite Correction Maxillary, Complex true true false 0 3 0011 0 false 81124 19 O Appliances,Removable,Cross- Bite Correction Mandibular, Complex Appliances,Removable,Cross- Bite Correction Mandibular, Complex true true false 0 3 0022 0 false 81131 19 O Appliances,Removable,Dental Arch Expansion-Maxillary, Simple Appliances,Removable,Dental Arch Expansion-Maxillary, Simple true true false 0 3 0011 0 false 81132 19 O Appliances,Removable,Dental Arch Expansion-Mandibular, Simple Appliances,Removable,Dental Arch Expansion-Mandibular, Simple true true false 0 3 0022 0 false 81133 19 O Appliances,Removable,Dental Arch Expansion-Maxillary, Complex Appliances,Removable,Dental Arch Expansion-Maxillary, Complex true true false 0 3 0011 0 false 81134 19 O Appliances,Removable,Dental Arch Expansion-Mandibular, Complex Appliances,Removable,Dental Arch Expansion-Mandibular, Complex true true false 0 3 0022 0 false 81135 19 O Appliances,Removable,Dental Arch Expansion-Maxillary, Rapid Expansion Appliances,Removable,Dental Arch Expansion-Maxillary, Rapid Expansion true true false 0 3 0011 0 false 81141 19 O Appliance,Removable,Closure of Diastemas-Maxillary,Simple Appliance,Removable,Closure of Diastemas-Maxillary,Simple true true false 0 3 0011 0 false 81142 19 O Appliance,Removable,Closure of Diastemas-Mandibular, Simple Appliance,Removable,Closure of Diastemas-Mandibular, Simple true true false 0 3 0022 0 false 81143 19 O Appliance,Removable,Closure of Diastemas-Maxillary, Complex Appliance,Removable,Closure of Diastemas-Maxillary, Complex true true false 0 3 0011 0 false 81144 19 O Appliance,Removable,Closure of Diastemas-Mandibular, Complex Appliance,Removable,Closure of Diastemas-Mandibular, Complex true true false 0 3 0022 0 false 81151 19 O Appliances,Removable, Alignment of Anterior Teeth- Maxillary,Simple Appliances,Removable, Alignment of Anterior Teeth- Maxillary,Simple true true false 0 3 0011 0 false 81152 19 O Appliances,Removable, Alignment of Anterior Teeth- Mandibular,Simple Appliances,Removable, Alignment of Anterior Teeth- Mandibular,Simple true true false 0 3 0022 0 false 81153 19 O Appliances,Removable, Alignment of Anterior Teeth- Maxillary,Complex Appliances,Removable, Alignment of Anterior Teeth- Maxillary,Complex true true false 0 3 0011 0 false 81154 19 O Appliances,Removable, Alignment of Anterior Teeth- Mandibular,Complex Appliances,Removable, Alignment of Anterior Teeth- Mandibular,Complex true true false 0 3 0022 0 false 81161 19 O Appl,Mech,Max + L Appl,Mech,Max + L false false false 0 0 1919 MODBLIV false 81162 19 O Appl,Mech,Max + L Appl,Mech,Max + L false false false 0 0 1919 MODBLIV false 81163 19 O Appli/Maxillary,Erupted Appli/Maxillary,Erupted false false false 0 0 1919 MODBLIV false 81164 19 O Appli/Mandibular,Erupted Appli/Mandibular,Erupted false false false 0 0 1919 MODBLIV false 81211 19 O Appliance,Fixed,Space Regaining-Maxillary Appliance,Fixed,Space Regaining-Maxillary true true false 0 3 0011 0 false 81212 19 O Appliance,Fixed,Space Regaining-Mandibular Appliance,Fixed,Space Regaining-Mandibular true true false 0 3 0022 0 false 81221 19 O Appliance,Fixed,Space Regaining,Unilateral-Maxillary Appliance,Fixed,Space Regaining,Unilateral-Maxillary true true false 0 3 0011 0 false 81222 19 O Appliance,Fixed,Space Regaining,Unilateral- Mandibular Appliance,Fixed,Space Regaining,Unilateral- Mandibular true true false 0 3 0022 0 false 81231 19 O Appliance,Fixed,Cross-Bite Correction-Anterior-Maxillary Appliance,Fixed,Cross-Bite Correction-Anterior-Maxillary true true false 0 3 0011 0 false 81232 19 O Appliance,Fixed,Cross-Bite Correction-Anterior-Mandibular Appliance,Fixed,Cross-Bite Correction-Anterior-Mandibular true true false 0 3 0022 0 false 81241 19 O Appliance,Fixed,Cross-Bite Correction-Posterior-Maxillary Appliance,Fixed,Cross-Bite Correction-Posterior-Maxillary true true false 0 3 0011 0 false 81242 19 O Appliance,Fixed,Cross-Bite Correction-Posterior-Mandibular Appliance,Fixed,Cross-Bite Correction-Posterior-Mandibular true true false 0 3 0022 0 false 81243 19 O Appliance,Fixed,Cross-Bite Correction-Posterior-2-Molar Band,Hooked&Elastics Appliance,Fixed,Cross-Bite Correction-Posterior-2-Molar Band,Hooked&Elastics true false false 0 0 false 81251 19 O Appliance,Fixed,Dental Arch Expansion-Maxillary Appliance,Fixed,Dental Arch Expansion-Maxillary true true false 0 3 0011 0 false 81252 19 O Appliance,Fixed,Dental Arch Expansion-Mandibular Appliance,Fixed,Dental Arch Expansion-Mandibular true true false 0 3 0022 0 false 81253 19 O Appliance,Fixed,Dental Arch Expansion-Maxillary,Rapid Expansion Appliance,Fixed,Dental Arch Expansion-Maxillary,Rapid Expansion true true false 0 3 0011 0 false 81254 19 O Appliance,Fixed,Dental Arch Expansion-Headgear Appliance,Fixed,Dental Arch Expansion-Headgear true false false 0 0 false 81261 19 O Appliance,Fixed,Closure of Diastemas-Maxillary,Simple Appliance,Fixed,Closure of Diastemas-Maxillary,Simple true true false 0 3 0011 0 false 81262 19 O Appliance,Fixed,Closure of Diastemas-Mandibular,Simple Appliance,Fixed,Closure of Diastemas-Mandibular,Simple true true false 0 3 0022 0 false 81263 19 O Appliance,Fixed,Closure of Diastemas-Maxillary,Complex Appliance,Fixed,Closure of Diastemas-Maxillary,Complex true true false 0 3 0011 0 false 81264 19 O Appliance,Fixed,Closure of Diastemas-Mandibular, Complex Appliance,Fixed,Closure of Diastemas-Mandibular, Complex true true false 0 3 0022 0 false 81271 19 O Appliance,Fixed, Alignment of Incisor Teeth-Maxillary,Simple Appliance,Fixed, Alignment of Incisor Teeth-Maxillary,Simple true true false 0 3 0011 0 false 81272 19 O Appliance,Fixed, Alignment of Incisor Teeth-Mandibular, Simple Appliance,Fixed, Alignment of Incisor Teeth-Mandibular, Simple true true false 0 3 0022 0 false 81273 19 O Appliance,Fixed, Alignment of Incisor Teeth-Maxillary, Complex Appliance,Fixed, Alignment of Incisor Teeth-Maxillary, Complex true true false 0 3 0011 0 false 81274 19 O Appliance,Fixed, Alignment of Incisor Teeth-Mandibular, Complex Appliance,Fixed, Alignment of Incisor Teeth-Mandibular, Complex true true false 0 3 0022 0 false 81281 19 O Grassline Or Elastic Liga Grassline Or Elastic Liga false false false 0 0 1919 MODBLIV false 81290 19 O Appl/Fix/Mech Eruption Appl/Fix/Mech Eruption false false false 0 0 1919 0 MODBLIV false 81291 19 O Appliance,Fixed,Mechanical Eruption of Tooth/Teeth- Maxillary,Impaction Appliance,Fixed,Mechanical Eruption of Tooth/Teeth- Maxillary,Impaction true true false 0 3 0011 0 false 81292 19 O Appliance,Fixed,Mechanical Eruption of Tooth/Teeth- Mandibular,Impaction Appliance,Fixed,Mechanical Eruption of Tooth/Teeth- Mandibular,Impaction true true false 0 3 0022 0 false 81293 19 O Appliance,Fixed,Mechanical Eruption of Tooth/Teeth- Maxillary,Erupted Appliance,Fixed,Mechanical Eruption of Tooth/Teeth- Maxillary,Erupted true true false 0 3 0011 0 false 81294 19 O Appliance,Fixed,Mechanical Eruption of Tooth/Teeth- Mandibular,Erupted Appliance,Fixed,Mechanical Eruption of Tooth/Teeth- Mandibular,Erupted true true false 0 3 0022 0 false 83101 19 O Appliance,Removable, Retention-Maxillary Appliance,Removable, Retention-Maxillary true true false 0 3 0011 0 false 83102 19 O Appliance,Removable, Retention-Mandibular Appliance,Removable, Retention-Mandibular true true false 0 3 0022 0 false 83103 19 O Appliance,Removable, Retention-Tooth Positioner Appliance,Removable, Retention-Tooth Positioner true true false 0 0 1818 0 false 83201 19 O Appliances,Fixed/Cemented, Retention-Maxillary Appliances,Fixed/Cemented, Retention-Maxillary true true false 0 3 0011 0 false 83202 19 O Appliances,Fixed/Cemented, Retention-Mandibular Appliances,Fixed/Cemented, Retention-Mandibular true true false 0 3 0022 0 false 84101 19 O Fixed Appliance Permanent Dentition-Class I Malocclusion Fixed Appliance Permanent Dentition-Class I Malocclusion true false false 0 0 false 84201 19 O Fixed Appliance Permanent Dentition-Class II Malocclusion Fixed Appliance Permanent Dentition-Class II Malocclusion true false false 0 0 false 84301 19 O Fixed Appliance Permanent Dentition-Class III Malocclusion Fixed Appliance Permanent Dentition-Class III Malocclusion true false false 0 0 false 84401 19 O Fixed Appliance Permanent Dentition- Malocclusions not Requiring Complete Banding Fixed Appliance Permanent Dentition- Malocclusions not Requiring Complete Banding true false false 0 0 false 85101 19 O Fixed Appliance Mixed Dentition-Class I Malocclusion Fixed Appliance Mixed Dentition-Class I Malocclusion true false false 0 0 false 85201 19 O Fixed Appliance Mixed Dentition-Class II Malocclusion Fixed Appliance Mixed Dentition-Class II Malocclusion true false false 0 0 false 85301 19 O Fixed Appliance Mixed Dentition-Class III Malocclusion Fixed Appliance Mixed Dentition-Class III Malocclusion true false false 0 0 false 86101 19 O Fixed Appliance Primary Dentition-Class I Malocclusion Fixed Appliance Primary Dentition-Class I Malocclusion true false false 0 0 false 86201 19 O Fixed Appliance Primary Dentition-Class II Malocclusion Fixed Appliance Primary Dentition-Class II Malocclusion true false false 0 0 false 86301 19 O Fixed Appliance Primary Dentition-Class III Malocclusion Fixed Appliance Primary Dentition-Class III Malocclusion true false false 0 0 false 87101 19 O Removable Appliances Permanent Dentition- Class I Malocclusion Removable Appliances Permanent Dentition- Class I Malocclusion true false false 0 0 false 87201 19 O Removable Appliances Permanent Dentition- Class II Malocclusion Removable Appliances Permanent Dentition- Class II Malocclusion true false false 0 0 false 87301 19 O Removable Appliances Permanent Dentition- Class III Malocclusion Removable Appliances Permanent Dentition- Class III Malocclusion true false false 0 0 false 88101 19 O Removable Appliances Mixed Dentition- Class I Malocclusion Removable Appliances Mixed Dentition- Class I Malocclusion true false false 0 0 false 88201 19 O Removable Appliances Mixed Dentition- Class II Malocclusion Removable Appliances Mixed Dentition- Class II Malocclusion true false false 0 0 false 88301 19 O Removable Appliances Mixed Dentition- Class III Malocclusion Removable Appliances Mixed Dentition- Class III Malocclusion true false false 0 0 false 89101 19 O Removable Appliances Primary Dentition- Class I Malocclusion Removable Appliances Primary Dentition- Class I Malocclusion true false false 0 0 false 89201 19 O Removable Appliances Primary Dentition- Class II Malocclusion Removable Appliances Primary Dentition- Class II Malocclusion true false false 0 0 false 89301 19 O Removable Appliances Primary Dentition- Class III Malocclusion Removable Appliances Primary Dentition- Class III Malocclusion true false false 0 0 false 89501 19 O Expansion Appliance,Infan Expansion Appliance,Infan false false false 0 0 1919 MODBLIV false 89502 19 O Extra Appliance,Infants Extra Appliance,Infants false false false 0 0 1919 MODBLIV false 89503 19 O Stage I-Initial Expansion Stage I-Initial Expansion false false false 0 0 1919 MODBLIV false 89504 19 O Stage Ii-Anterior Align Stage Ii-Anterior Align false false false 0 0 1919 MODBLIV false 89505 19 O Stage Iii-Final Align Stage Iii-Final Align false false false 0 0 1919 MODBLIV false 89506 19 O Stage Iii-Stage I&ii Not Stage Iii-Stage I&ii Not false false false 0 0 1919 MODBLIV false 89700 19 O Ortho Monthly Fee Ortho Monthly Fee false false false 0 0 false 89701 19 O Ortho Initial Fee Ortho Initial Fee false false false 0 0 false 89702 19 O Ortho Diagnostic Records Ortho Diagnostic Records false false false 0 0 false 89703 19 O Ortho One Time Appliance Ortho One Time Appliance false false false 0 0 false 89704 19 O Ortho Quarterly Fee Ortho Quarterly Fee false false false 0 0 false 89705 19 O Ortho Repairs Ortho Repairs false false false 0 0 false 89706 19 O Ortho Miscellaneous(Excluding late or financing charges,interest and insurance charges.) Ortho Miscellaneous(Excluding late or financing charges,interest and insurance charges.) false false false 0 0 false 91111 20 X Palliative Treatment,1uni Palliative Treatment,1uni false false false 0 0 1919 MODBLIV false 91112 20 X Palliative Treatment,2uni Palliative Treatment,2uni false false false 0 0 1919 MODBLIV false 91113 20 X Palliative Treatment,3uni Palliative Treatment,3uni false false false 0 0 1919 MODBLIV false 91119 20 X Palliative Treatment,Addi Palliative Treatment,Addi false false false 0 0 1919 MODBLIV false 91121 20 X Emergency Services,1unit Emergency Services,1unit false false false 0 0 1919 0 MODBLIV false 91122 20 X Emergency Services - 2 Un Emergency Services - 2 Un false false false 0 0 1919 0 MODBLIV false 91123 20 X Emergency Services - 3 Un Emergency Services - 3 Un false false false 0 0 1919 0 MODBLIV false 91129 20 X Emergency Services-Over 3 Emergency Services-Over 3 false false false 0 0 1919 0 MODBLIV false 91211 20 X Unclassified Treatment, Unusual Time& Responsiblities -1 Unit of Time Unclassified Treatment, Unusual Time& Responsiblities -1 Unit of Time false false false 0 0 false 91212 20 X Unclassified Treatment, Unusual Time& Responsiblities -2 Units of Time Unclassified Treatment, Unusual Time& Responsiblities -2 Units of Time false false false 0 0 false 91213 20 X Unclassified Treatment, Unusual Time& Responsiblities -3 Units of Time Unclassified Treatment, Unusual Time& Responsiblities -3 Units of Time false false false 0 0 false 91219 20 X Unclassified Treatment, Unusual Time& Responsiblities -Each Add Unit over 3 Unclassified Treatment, Unusual Time& Responsiblities -Each Add Unit over 3 false false false 0 0 false 91221 20 X Second Surgeon ( Team App Second Surgeon ( Team App false false false 0 0 1919 MODBLIV false 91222 20 X Second Surgeon ( Team App Second Surgeon ( Team App false false false 0 0 1919 MODBLIV false 91223 20 X Second Surgeon ( Team App Second Surgeon ( Team App false false false 0 0 1919 MODBLIV false 91224 20 X Second Surgeon ( Team App Second Surgeon ( Team App false false false 0 0 1919 MODBLIV false 91225 20 X Second Surgeon ( Team App Second Surgeon ( Team App false false false 0 0 1919 MODBLIV false 91226 20 X Second Surgeon ( Team App Second Surgeon ( Team App false false false 0 0 1919 MODBLIV false 91227 20 X Second Surgeon ( Team App Second Surgeon ( Team App false false false 0 0 1919 MODBLIV false 91228 20 X Second Surgeon ( Team App Second Surgeon ( Team App false false false 0 0 1919 MODBLIV false 91229 20 X Second Surgeon ( Team App Second Surgeon ( Team App false false false 0 0 1919 MODBLIV false 91231 20 X Management Of Exceptional Management Of Exceptional false false false 0 0 1919 0 MODBLIV false 91232 20 X Management Of Exceptional Management Of Exceptional false false false 0 0 1919 0 MODBLIV false 91233 20 X Management Of Exceptional Management Of Exceptional false false false 0 0 1919 0 MODBLIV false 91234 20 X Management Of Exceptional Management Of Exceptional false false false 0 0 1919 0 MODBLIV false 91239 20 X Management Of Exceptional Management Of Exceptional false false false 0 0 1919 0 MODBLIV false 92101 20 X Regional Block Anesthesia Regional Block Anesthesia false false false 0 0 false 92102 20 X Trigeminal Division Block Trigeminal Division Block false false false 0 0 false 92211 20 X Local Anaesthetic 1 Unit Local Anaesthetic 1 Unit false false false 0 0 1919 0 MODBLIV false 92212 20 X General Anaesthesia- 2 Units of Time General Anaesthesia- 2 Units of Time false false false 0 0 false 92213 20 X General Anaesthesia- 3 Units of Time General Anaesthesia- 3 Units of Time false false false 0 0 false 92214 20 X General Anaesthesia- 4 Units of Time General Anaesthesia- 4 Units of Time false false false 0 0 false 92215 20 B General Anaesthesia- 5 Units of Time General Anaesthesia- 5 Units of Time false false false 0 0 false 92216 20 X General Anaesthesia- 6 Units of Time General Anaesthesia- 6 Units of Time false false false 0 0 false 92217 20 X General Anaesthesia- 7 Units of Time General Anaesthesia- 7 Units of Time false false false 0 0 false 92218 20 X General Anaesthesia- 8 Units of Time General Anaesthesia- 8 Units of Time false false false 0 0 false 92219 20 X General Anaesthesia- Each Add Unit over 8 General Anaesthesia- Each Add Unit over 8 false false false 0 0 false 92221 20 X Provision of Facilities, Equipment & Support Services For General Anesthesia Provide by Separate Practitioner-1 Unit of Time Provision of Facilities, Equipment & Support Services For General Anesthesia Provide by Separate Practitioner-1 Unit of Time false false false 0 0 false 92222 20 X Provision of Facilities, Equipment & Support Services For General Anesthesia Provide by Separate Practitioner-2 Units of Time Provision of Facilities, Equipment & Support Services For General Anesthesia Provide by Separate Practitioner-2 Units of Time false false false 0 0 false 92223 20 X Facilities,3 Units Facilities,3 Units false false false 0 0 1919 0 MODBLIV false 92224 20 X Facilities,4 Units Facilities,4 Units false false false 0 0 1919 0 MODBLIV false 92225 20 X Facilities - 5 Units Facilities - 5 Units false false false 0 0 1919 0 MODBLIV false 92226 20 X Facilities,6 Units Facilities,6 Units false false false 0 0 1919 0 MODBLIV false 92227 20 X Facilities,7 Units Facilities,7 Units false false false 0 0 1919 0 MODBLIV false 92228 20 X Facilities - 8 Units Facilities - 8 Units false false false 0 0 1919 0 MODBLIV false 92229 20 X Provision of Facilities, Equipment & Support Services For General Anesthesia Provide by Separate Practitioner-Each Add Unit over 2 Provision of Facilities, Equipment & Support Services For General Anesthesia Provide by Separate Practitioner-Each Add Unit over 2 false false false 0 0 false 92252 20 X Neuroleptanalgesia 2 Unit Neuroleptanalgesia 2 Unit false false false 0 0 1919 0 MODBLIV false 92253 20 X Neuroleptanalgesia 3 Unit Neuroleptanalgesia 3 Unit false false false 0 0 1919 0 MODBLIV false 92254 20 X Neuroleptanalgesia 4 Unit Neuroleptanalgesia 4 Unit false false false 0 0 1919 0 MODBLIV false 92255 20 X Neuroleptanalgesia 5 Unit Neuroleptanalgesia 5 Unit false false false 0 0 1919 0 MODBLIV false 92256 20 X Neuroleptanalgesia 6 Unit Neuroleptanalgesia 6 Unit false false false 0 0 1919 0 MODBLIV false 92257 20 X Neuroleptanalgesia 7 Unit Neuroleptanalgesia 7 Unit false false false 0 0 1919 0 MODBLIV false 92258 20 X Neuroleptanalgesia 8 Unit Neuroleptanalgesia 8 Unit false false false 0 0 1919 0 MODBLIV false 92259 20 X Neuroleptanalgesia Add. Neuroleptanalgesia Add. false false false 0 0 1919 0 MODBLIV false 92301 20 X Anesthesia,Deep Sedation- 1 Unit of Time Anesthesia,Deep Sedation- 1 Unit of Time false false false 0 0 false 92302 20 X Anesthesia,Deep Sedation- 2Units of Time Anesthesia,Deep Sedation- 2Units of Time false false false 0 0 false 92303 20 X Anesthesia,Deep Sedation- 3Units of Time Anesthesia,Deep Sedation- 3Units of Time false false false 0 0 1919 MODBLIV false 92304 20 X Anesthesia,Deep Sedation- 4Units of Time Anesthesia,Deep Sedation- 4Units of Time false false false 0 0 1919 MODBLIV false 92305 20 X Anesthesia,Deep Sedation- 5Units of Time Anesthesia,Deep Sedation- 5Units of Time false false false 0 0 1919 MODBLIV false 92306 20 X Anesthesia,Deep Sedation- 6Units of Time Anesthesia,Deep Sedation- 6Units of Time false false false 0 0 1919 MODBLIV false 92307 20 X Anesthesia,Deep Sedation- 7Units of Time Anesthesia,Deep Sedation- 7Units of Time false false false 0 0 1919 MODBLIV false 92308 20 X Anesthesia,Deep Sedation- 8Units of Time Anesthesia,Deep Sedation- 8Units of Time false false false 0 0 1919 MODBLIV false 92309 20 X Anesthesia,Deep Sedation- Each Add Unit over 2 Anesthesia,Deep Sedation- Each Add Unit over 2 false false false 0 0 false 92311 20 X Inhala/Anaesth/Cons 1 Unt Inhala/Anaesth/Cons 1 Unt false false false 0 0 1919 0 MODBLIV false 92312 20 X Inhala/Anaesth/Cons 2 Unt Inhala/Anaesth/Cons 2 Unt false false false 0 0 1919 0 MODBLIV false 92313 20 X Inhala/Anaesth/Cons 3 Unt Inhala/Anaesth/Cons 3 Unt false false false 0 0 1919 0 MODBLIV false 92314 20 X Inhala/Anaesth/Cons 4 Unt Inhala/Anaesth/Cons 4 Unt false false false 0 0 1919 0 MODBLIV false 92315 20 X Inhala/Anaesth/Cons 5 Unt Inhala/Anaesth/Cons 5 Unt false false false 0 0 1919 0 MODBLIV false 92316 20 X Inhala/Anaesth/Cons 6 Unt Inhala/Anaesth/Cons 6 Unt false false false 0 0 1919 0 MODBLIV false 92317 20 X Inhala/Anaesth/Cons 7 Unt Inhala/Anaesth/Cons 7 Unt false false false 0 0 1919 0 MODBLIV false 92318 20 X Inhala/Anaesth/Cons 8 Unt Inhala/Anaesth/Cons 8 Unt false false false 0 0 1919 0 MODBLIV false 92322 20 X Prov Of Fac/Equip&sup 2un Prov Of Fac/Equip&sup 2un false false false 0 0 1919 0 MODBLIV false 92323 20 X Prov Of Fac/Equip&sup 3un Prov Of Fac/Equip&sup 3un false false false 0 0 1919 0 MODBLIV false 92324 20 X Prov Of Fac/Equip&sup 4un Prov Of Fac/Equip&sup 4un false false false 0 0 1919 0 MODBLIV false 92325 20 X Prov Of Fac/Equip&sup 5un Prov Of Fac/Equip&sup 5un false false false 0 0 1919 0 MODBLIV false 92326 20 X Prov Of Fac/Equip&sup 6un Prov Of Fac/Equip&sup 6un false false false 0 0 1919 0 MODBLIV false 92327 20 X Prov Of Fac/Equip&sup 7un Prov Of Fac/Equip&sup 7un false false false 0 0 1919 0 MODBLIV false 92328 20 X Prov Of Fac/Equip&sup 8un Prov Of Fac/Equip&sup 8un false false false 0 0 1919 0 MODBLIV false 92329 20 X Prov Of Fac/Equip&sup Add Prov Of Fac/Equip&sup Add false false false 0 0 1919 0 MODBLIV false 92331 20 X Intravenous Sedate 1 Unit Intravenous Sedate 1 Unit false false false 0 0 1919 0 MODBLIV false 92332 20 X Intravenous Sedate 2 Unit Intravenous Sedate 2 Unit false false false 0 0 1919 0 MODBLIV false 92333 20 X Intravenous Sedate 3 Unit Intravenous Sedate 3 Unit false false false 0 0 1919 0 MODBLIV false 92334 20 X Intravenous Sedate 4 Unit Intravenous Sedate 4 Unit false false false 0 0 1919 0 MODBLIV false 92335 20 X Intravenous Sedate 5 Unit Intravenous Sedate 5 Unit false false false 0 0 1919 0 MODBLIV false 92336 20 X Intravenous Sedate 6 Unit Intravenous Sedate 6 Unit false false false 0 0 1919 0 MODBLIV false 92337 20 X Intravenous Sedate 7 Unit Intravenous Sedate 7 Unit false false false 0 0 1919 0 MODBLIV false 92338 20 X Intravenous Sedate 8 Unit Intravenous Sedate 8 Unit false false false 0 0 1919 0 MODBLIV false 92339 20 X Intravenous Sedate Add. Intravenous Sedate Add. false false false 0 0 1919 0 MODBLIV false 92341 20 X Intrmusc Inject Sedative Intrmusc Inject Sedative false false false 0 0 1919 0 MODBLIV false 92351 20 X Combined Tech, 1 Unit Combined Tech, 1 Unit false false false 0 0 1919 MODBLIV false 92352 20 X Combined Tech,2 Units Combined Tech,2 Units false false false 0 0 1919 MODBLIV false 92353 20 X Combined Tech,3 Units Combined Tech,3 Units false false false 0 0 1919 MODBLIV false 92354 20 X Combined Tech,4 Units Combined Tech,4 Units false false false 0 0 1919 MODBLIV false 92355 20 X Combined Tech,5 Units Combined Tech,5 Units false false false 0 0 1919 MODBLIV false 92356 20 X Combined Tech,6 Units Combined Tech,6 Units false false false 0 0 1919 MODBLIV false 92357 20 X Combined Tech,7 Units Combined Tech,7 Units false false false 0 0 1919 MODBLIV false 92358 20 X Combined Tech,8 Units Combined Tech,8 Units false false false 0 0 1919 MODBLIV false 92359 20 X Combined Tech,+8 Units Combined Tech,+8 Units false false false 0 0 1919 MODBLIV false 92361 20 X Hypnosis 1 Unit Hypnosis 1 Unit false false false 0 0 1919 0 MODBLIV false 92362 20 X Hypnosis 2 Units Hypnosis 2 Units false false false 0 0 1919 0 MODBLIV false 92363 20 X Hypnosis 3 Units Hypnosis 3 Units false false false 0 0 1919 0 MODBLIV false 92364 20 X Hypnosis 4 Units Hypnosis 4 Units false false false 0 0 1919 0 MODBLIV false 92369 20 X Hypnosis Add. Hypnosis Add. false false false 0 0 1919 0 MODBLIV false 92371 20 X Acupuncture 1 Unit Acupuncture 1 Unit false false false 0 0 1919 0 MODBLIV false 92372 20 X Acupuncture 2 Units Acupuncture 2 Units false false false 0 0 1919 0 MODBLIV false 92373 20 X Acupuncture 3 Units Acupuncture 3 Units false false false 0 0 1919 0 MODBLIV false 92374 20 X Acupuncture 4 Units Acupuncture 4 Units false false false 0 0 1919 0 MODBLIV false 92379 20 X Acupuncture Add. Acupuncture Add. false false false 0 0 1919 0 MODBLIV false 92411 20 X Anesthesia,Conscious Sedation- Nitrous Oxide- 1 Unit of Time Anesthesia,Conscious Sedation- Nitrous Oxide- 1 Unit of Time false false false 0 0 false 92412 20 X Anesthesia,Conscious Sedation- Nitrous Oxide- 2 Units of Time Anesthesia,Conscious Sedation- Nitrous Oxide- 2 Units of Time false false false 0 0 false 92413 20 X Inhalation Technique/3 Un Inhalation Technique/3 Un false false false 0 0 1919 0 MODBLIV false 92414 20 X Inhalation Technique/4 Un Inhalation Technique/4 Un false false false 0 0 1919 0 MODBLIV false 92415 20 X Inhalation Technique/5 Un Inhalation Technique/5 Un false false false 0 0 1919 MODBLIV false 92416 20 X Inhalation Technique/Six Inhalation Technique/Six false false false 0 0 1919 MODBLIV false 92417 20 X Inhalation Technique/7 Un Inhalation Technique/7 Un false false false 0 0 1919 MODBLIV false 92418 20 X Inhalation Technique/8 Un Inhalation Technique/8 Un false false false 0 0 1919 MODBLIV false 92419 20 X Anesthesia,Conscious Sedation- Nitrous Oxide- Each Add Unit over 2 Anesthesia,Conscious Sedation- Nitrous Oxide- Each Add Unit over 2 false false false 0 0 false 92421 20 X Anesthesia,Conscious Sedation- Oral Sedation-1 Unit of Time Anesthesia,Conscious Sedation- Oral Sedation-1 Unit of Time false false false 0 0 false 92422 20 X Anesthesia,Conscious Sedation- Oral Sedation-2 Units of Time Anesthesia,Conscious Sedation- Oral Sedation-2 Units of Time false false false 0 0 false 92423 20 X Oralsed 3 Unit Oralsed 3 Unit false false false 0 0 1919 0 MODBLIV false 92424 20 X Oralsed 4 Unit Oralsed 4 Unit false false false 0 0 1919 0 MODBLIV false 92425 20 X Oralsed 5 Unit Oralsed 5 Unit false false false 0 0 1919 MODBLIV false 92426 20 X Oralsed 6 Unit Oralsed 6 Unit false false false 0 0 1919 MODBLIV false 92427 20 X Oralsed 7 Unit Oralsed 7 Unit false false false 0 0 1919 MODBLIV false 92428 20 X Oralsed 8 Unit Oralsed 8 Unit false false false 0 0 1919 MODBLIV false 92429 20 X Anesthesia,Conscious Sedation- Oral Sedation-Each Add Unit over 2 Anesthesia,Conscious Sedation- Oral Sedation-Each Add Unit over 2 false false false 0 0 false 92431 20 X Anesthesia,Conscious Sedation- Nitrous Oxide W/ Oral Sedation-1 Unit of Time Anesthesia,Conscious Sedation- Nitrous Oxide W/ Oral Sedation-1 Unit of Time false false false 0 0 false 92432 20 X Anesthesia,Conscious Sedation- Nitrous Oxide W/ Oral Sedation-2 Units of Time Anesthesia,Conscious Sedation- Nitrous Oxide W/ Oral Sedation-2 Units of Time false false false 0 0 false 92433 20 X Nitrous Oxide W/ Oral Sedation-3 Units of Time Nitrous Oxide W/ Oral Sedation-3 Units of Time false false false 0 0 1919 MODBLIV false 92434 20 X Nitrous Oxide W/ Oral Sedation-4 Units of Time Nitrous Oxide W/ Oral Sedation-4 Units of Time false false false 0 0 1919 MODBLIV false 92435 20 X Nitrous Oxide W/ Oral Sedation-5 Units of Time Nitrous Oxide W/ Oral Sedation-5 Units of Time false false false 0 0 1919 MODBLIV false 92436 20 X Nitrous Oxide W/ Oral Sedation-6 Units of Time Nitrous Oxide W/ Oral Sedation-6 Units of Time false false false 0 0 1919 MODBLIV false 92437 20 X Nitrous Oxide W/ Oral Sedation-7 Units of Time Nitrous Oxide W/ Oral Sedation-7 Units of Time false false false 0 0 1919 MODBLIV false 92438 20 X Nitrous Oxide W/ Oral Sedation-8 Units of Time Nitrous Oxide W/ Oral Sedation-8 Units of Time false false false 0 0 1919 MODBLIV false 92439 20 X Anesthesia,Conscious Sedation- Nitrous Oxide W/ Oral Sedation-Each Add Unit of Time Anesthesia,Conscious Sedation- Nitrous Oxide W/ Oral Sedation-Each Add Unit of Time false false false 0 0 false 92441 20 X Anesthesia, Parental Conscious Sedation- 1 Unit of Time Anesthesia, Parental Conscious Sedation- 1 Unit of Time false false false 0 0 false 92442 20 X Anesthesia, Parental Conscious Sedation- 2 Units of Time Anesthesia, Parental Conscious Sedation- 2 Units of Time false false false 0 0 false 92443 20 X Anesthesia, Parental Conscious Sedation- 3 Units of Time Anesthesia, Parental Conscious Sedation- 3 Units of Time false false false 0 0 1919 0 MODBLIV false 92444 20 X Anesthesia, Parental Conscious Sedation- 4 Units of Time Anesthesia, Parental Conscious Sedation- 4 Units of Time false false false 0 0 1919 0 MODBLIV false 92445 20 X Anesthesia, Parental Conscious Sedation- 5 Units of Time Anesthesia, Parental Conscious Sedation- 5 Units of Time false false false 0 0 1919 0 MODBLIV false 92446 20 X Anesthesia, Parental Conscious Sedation- 6 Units of Time Anesthesia, Parental Conscious Sedation- 6 Units of Time false false false 0 0 1919 0 MODBLIV false 92447 20 X Anesthesia, Parental Conscious Sedation- 7 Units of Time Anesthesia, Parental Conscious Sedation- 7 Units of Time false false false 0 0 1919 0 MODBLIV false 92448 20 X Anesthesia, Parental Conscious Sedation- 8 Units of Time Anesthesia, Parental Conscious Sedation- 8 Units of Time false false false 0 0 1919 0 MODBLIV false 92449 20 X Anesthesia, Parental Conscious Sedation- Each Add Unit over 8 Anesthesia, Parental Conscious Sedation- Each Add Unit over 8 false false false 0 0 false 92451 20 X Anesthesia Conscious Sedation- Combine Techniq of Inhale+ Intraven& Intrmuscul Injection-1 Unit of Time Anesthesia Conscious Sedation- Combine Techniq of Inhale+ Intraven& Intrmuscul Injection-1 Unit of Time false false false 0 0 false 92452 20 X Anesthesia Conscious Sedation- Combine Techniq of Inhale+ Intraven& Intrmuscul Injection-2 Units of Time Anesthesia Conscious Sedation- Combine Techniq of Inhale+ Intraven& Intrmuscul Injection-2 Units of Time false false false 0 0 false 92453 20 X Combined Inhalation & Iv Combined Inhalation & Iv false false false 0 0 1919 MODBLIV false 92454 20 X Combined Inhalation & Iv Combined Inhalation & Iv false false false 0 0 1919 MODBLIV false 92455 20 X Combined Inhalation & Iv Combined Inhalation & Iv false false false 0 0 1919 MODBLIV false 92456 20 X Combined Inhalation & Iv Combined Inhalation & Iv false false false 0 0 1919 MODBLIV false 92457 20 X Combined Inhalation + IV, 7 units Combined Inhalation + IV, 7 units false false false 0 0 false 0 92458 20 X Combined Inhalation & Iv Combined Inhalation & Iv false false false 0 0 1919 MODBLIV false 92459 20 X Anesthesia Conscious Sedation- Combine Techniq of Inhale+ Intraven& Intrmuscul Injection-Each Add Unit over 2 Anesthesia Conscious Sedation- Combine Techniq of Inhale+ Intraven& Intrmuscul Injection-Each Add Unit over 2 false false false 0 0 false 92461 20 X Oral Sed 1 Unit Oral Sed 1 Unit false false false 0 0 1919 MODBLIV false 92462 20 X Oral Sed 2 Units Oral Sed 2 Units false false false 0 0 1919 MODBLIV false 92463 20 X Oral Sed 3 Units Oral Sed 3 Units false false false 0 0 1919 MODBLIV false 92464 20 X Oral Sed 4 Units Oral Sed 4 Units false false false 0 0 1919 MODBLIV false 92465 20 X Oral Sed 5 Units Oral Sed 5 Units false false false 0 0 1919 MODBLIV false 92466 20 X Oral Sed 6 Units Oral Sed 6 Units false false false 0 0 1919 MODBLIV false 92467 20 X Oral Sed 7 Units Oral Sed 7 Units false false false 0 0 1919 MODBLIV false 92468 20 X Oral Sed 8 Units Oral Sed 8 Units false false false 0 0 1919 MODBLIV false 92469 20 X Oral Sed Add Units Oral Sed Add Units false false false 0 0 1919 MODBLIV false 92511 20 X Non Pharmacological Pain Control&Patient Manage- Hypnosis- 1 Unit of Time Non Pharmacological Pain Control&Patient Manage- Hypnosis- 1 Unit of Time false false false 0 0 false 92512 20 X Non Pharmacological Pain Control&Patient Manage- Hypnosis- 2 Units of Time Non Pharmacological Pain Control&Patient Manage- Hypnosis- 2 Units of Time false false false 0 0 false 92513 20 X Hypnosis - Three Units Hypnosis - Three Units false false false 0 0 1919 MODBLIV false 92514 20 X Hypnosis - Four Units Hypnosis - Four Units false false false 0 0 1919 MODBLIV false 92519 20 X Non Pharmacological Pain Control&Patient Manage- Hypnosis- Each Add Unit over 2 Non Pharmacological Pain Control&Patient Manage- Hypnosis- Each Add Unit over 2 false false false 0 0 false 92521 20 X Non Pharmacological Pain Control&Patient Manage- Acupuncture- 1 Unit of Time Non Pharmacological Pain Control&Patient Manage- Acupuncture- 1 Unit of Time false false false 0 0 false 92522 20 X Non Pharmacological Pain Control&Patient Manage- Acupuncture- 2 Units of Time Non Pharmacological Pain Control&Patient Manage- Acupuncture- 2 Units of Time false false false 0 0 false 92523 20 X Acupuncture -Three Units Acupuncture -Three Units false false false 0 0 1919 MODBLIV false 92524 20 X Acupuncture -Four Units Acupuncture -Four Units false false false 0 0 1919 MODBLIV false 92529 20 X Non Pharmacological Pain Control&Patient Manage- Acupuncture- Each Add Unit over 2 Non Pharmacological Pain Control&Patient Manage- Acupuncture- Each Add Unit over 2 false false false 0 0 false 92531 20 X Non Pharmacological Pain Control&Patient Manage- Electronic Dental Anesthesia- 1 Unit of Time Non Pharmacological Pain Control&Patient Manage- Electronic Dental Anesthesia- 1 Unit of Time false false false 0 0 false 92532 20 X Non Pharmacological Pain Control&Patient Manage- Electronic Dental Anesthesia- 2 Units Of Time Non Pharmacological Pain Control&Patient Manage- Electronic Dental Anesthesia- 2 Units Of Time false false false 0 0 false 92533 20 X Ed Anesthesia 3 Unit Ed Anesthesia 3 Unit false false false 0 0 1919 MODBLIV false 92534 20 X Ed Anesthesia 4 Unit Ed Anesthesia 4 Unit false false false 0 0 1919 MODBLIV false 92539 20 X Non Pharmacological Pain Control&Patient Manage- Electronic Dental Anesthesia- Each Add Unit over 2 Non Pharmacological Pain Control&Patient Manage- Electronic Dental Anesthesia- Each Add Unit over 2 false false false 0 0 false 92557 20 X Inhale Combo 7 Units Inhale Combo 7 Units false false false 0 0 1919 MODBLIV false 92621 20 X Oral Sedation 1 Unit Oral Sedation 1 Unit false false false 0 0 1919 0 MODBLIV false 92622 20 X Oral Sedation 2 Unit Oral Sedation 2 Unit false false false 0 0 1919 0 MODBLIV false 92623 20 X Oral Sedation 3 Unit Oral Sedation 3 Unit false false false 0 0 1919 0 MODBLIV false 92624 20 X Oral Sedation 4 Unit Oral Sedation 4 Unit false false false 0 0 1919 0 MODBLIV false 92625 20 X Oral Sedation 5 Unit Oral Sedation 5 Unit false false false 0 0 1919 0 MODBLIV false 92626 20 X Oral Sedation 6 Unit Oral Sedation 6 Unit false false false 0 0 1919 0 MODBLIV false 92627 20 X Oral Sedation 7 Unit Oral Sedation 7 Unit false false false 0 0 1919 0 MODBLIV false 92628 20 X Oral Sedation 8 Unit Oral Sedation 8 Unit false false false 0 0 1919 0 MODBLIV false 92629 20 X Oral Sedation Add Unit Oral Sedation Add Unit false false false 0 0 1919 0 MODBLIV false 93111 20 B Professional Consultation W/ Member of the Profession/ Healthcare Provider- 1 Unit of Time Professional Consultation W/ Member of the Profession/ Healthcare Provider- 1 Unit of Time true false false 0 0 false 93112 20 X Professional Consultation W/ Member of the Profession/ Healthcare Provider- 2 Units of Time Professional Consultation W/ Member of the Profession/ Healthcare Provider- 2 Units of Time true false false 0 0 false 93119 20 X Professional Consultation W/ Member of the Profession/ Healthcare Provider- Each Add Unit over 2 Professional Consultation W/ Member of the Profession/ Healthcare Provider- Each Add Unit over 2 true false false 0 0 false 93121 20 X Dental Reports-Short, Factually Written/Verbal Communication Dental Reports-Short, Factually Written/Verbal Communication false false false 0 0 false 93122 20 X Dental-Legal Report- Comprehensive Written Report W/ Patient Approval,on Symptoms,History,Etc Dental-Legal Report- Comprehensive Written Report W/ Patient Approval,on Symptoms,History,Etc false false false 0 0 false 93123 20 X Dental-Legal Opinion- Comprehensive Written Report Primarily in the Field of Expert Opinion Dental-Legal Opinion- Comprehensive Written Report Primarily in the Field of Expert Opinion false false false 0 0 false 93129 20 X Writ/Tele Report Add. Writ/Tele Report Add. false false false 0 0 1919 0 MODBLIV false 93131 20 X Consultation/Participation During Autopsy-1 Unit of Time Consultation/Participation During Autopsy-1 Unit of Time true false false 0 0 false 93132 20 X Consultation/Participation During Autopsy-2 Units of Time Consultation/Participation During Autopsy-2 Units of Time true false false 0 0 false 93139 20 X Consultation/Participation During Autopsy-Each Add Unit over 2 Consultation/Participation During Autopsy-Each Add Unit over 2 true false false 0 0 false 93211 20 X Patient File Management- Duplication&Transfer of Patient's Dental Record at Request of Patient Patient File Management- Duplication&Transfer of Patient's Dental Record at Request of Patient false false false 0 0 false 93301 20 X Completing CDA "Blank" Approved Standard Claim Forms Completing CDA "Blank" Approved Standard Claim Forms false false false 0 0 false 93302 20 X Upon Request,Providing Written Treatment Plan/Outline for Patient Upon Request,Providing Written Treatment Plan/Outline for Patient false false false 0 0 false 93303 20 X Completing Prepaid Claim Forms which do no Conform W/ Code 93301 Completing Prepaid Claim Forms which do no Conform W/ Code 93301 false false false 0 0 false 93311 20 X Extraord Time Spent on Phone W/ 3rd Party Admin/Agent in Relation to Claim Form,Treat Plan,Etc..-1 Unit of Time Extraord Time Spent on Phone W/ 3rd Party Admin/Agent in Relation to Claim Form,Treat Plan,Etc..-1 Unit of Time true false false 0 0 false 93312 20 X Extraord Time Spent on Phone W/ 3rd Party Admin/Agent in Relation to Claim Form,Treat Plan,Etc..-2 Units of Time Extraord Time Spent on Phone W/ 3rd Party Admin/Agent in Relation to Claim Form,Treat Plan,Etc..-2 Units of Time true false false 0 0 false 93319 20 X Extraord Time Spent on Phone W/ 3rd Party Admin/Agent in Relation to Claim Form,Treat Plan,Etc..-Each Add Unit of Time Extraord Time Spent on Phone W/ 3rd Party Admin/Agent in Relation to Claim Form,Treat Plan,Etc..-Each Add Unit of Time true false false 0 0 false 93320 20 B Pre-Anaesthetic Work-up Fee Pre-Anaesthetic Work-up Fee false false false 0 0 false 93321 20 X Extraord Office Time Spent in Forwarding Predetermin Record/ Situation to 3rd Party -1 Unit of Time Extraord Office Time Spent in Forwarding Predetermin Record/ Situation to 3rd Party -1 Unit of Time true false false 0 0 false 93322 20 X Extraord Office Time Spent in Forwarding Predetermin Record/ Situation to 3rd Party -2 Units of Time Extraord Office Time Spent in Forwarding Predetermin Record/ Situation to 3rd Party -2 Units of Time true false false 0 0 false 93329 20 X Extraord Office Time Spent in Forwarding Predetermin Record/ Situation to 3rd Party -Each Add Unit of Time over 2 Extraord Office Time Spent in Forwarding Predetermin Record/ Situation to 3rd Party -Each Add Unit of Time over true false false 0 0 false 93331 20 X Payment/Installment for Ortho Treatment in Progress-1 Unit of Time Payment/Installment for Ortho Treatment in Progress-1 Unit of Time false false false 0 0 false 93332 20 X Payment/Installment for Ortho Treatment in Progress-Monthly Installment Payment Payment/Installment for Ortho Treatment in Progress-Monthly Installment Payment false false false 0 0 false 93333 20 X Payment/Installment for Ortho Treatment in Progress- Quarterly Installment Payment Payment/Installment for Ortho Treatment in Progress- Quarterly Installment Payment false false false 0 0 false 93334 20 X Payment/Installment for Ortho Treatment in Progress- 1 Time Appliance Payment/Installment for Ortho Treatment in Progress- 1 Time Appliance false false false 0 0 false 93438 20 X Anesthesia, Conscious Sedation. NO & Oral sedation. false false false 0 0 false 0 94101 20 X House Call, Non Emergency Visit House Call, Non Emergency Visit false false false 0 0 false 94102 20 B House Call,Emergency Visit, when One must Immediatly Leave Home,Office,Etc.. House Call,Emergency Visit, when One must Immediatly Leave Home,Office,Etc.. false false false 0 0 false 94201 20 B Non Emergency Institutional Calls Non Emergency Institutional Calls false false false 0 0 false 94202 20 X Hospital Call/Emergency Hospital Call/Emergency false false false 0 0 1919 0 MODBLIV false 94301 20 B Office/Institutional Visit,During Regular Scheduled Offics Hours Office/Institutional Visit,During Regular Scheduled Offics Hours false false false 0 0 false 94302 20 X Office/Institutional Visit, Unscheduled, After Regular Scheduled Office Hours Office/Institutional Visit, Unscheduled, After Regular Scheduled Office Hours false false false 0 0 false 94303 20 X Missed/Cancelled Appt, W/Insufficient Notice, During Regular Scheduled Office Hours Missed/Cancelled Appt, W/Insufficient Notice, During Regular Scheduled Office Hours false false false 0 0 false 94304 20 X Missed/Cancelled Appt, W/Insufficient Notice, Being a Special Appt Outside Regular Scheduled Office Hours Missed/Cancelled Appt, W/Insufficient Notice, Being a Special Appt Outside Regular Scheduled Office Hours false false false 0 0 false 94305 20 X Travelling Expenses Travelling Expenses false false false 0 0 false 94306 20 X Professional Visits- Out of Office Professional Visits- Out of Office false false false 0 0 false 94411 20 X Preparation as an Expert Witness-1 Unit of Time Preparation as an Expert Witness-1 Unit of Time false false false 0 0 false 94412 20 X Preparation as an Expert Witness-2 Units of Time Preparation as an Expert Witness-2 Units of Time false false false 0 0 false 94413 20 X Preparation as an Expert Witness-3 Units of Time Preparation as an Expert Witness-3 Units of Time false false false 0 0 false 94414 20 X Preparation as an Expert Witness-4 Units of Time Preparation as an Expert Witness-4 Units of Time false false false 0 0 false 94419 20 X Preparation as an Expert Witness-Each Add Unit over 4 Preparation as an Expert Witness-Each Add Unit over 4 false false false 0 0 false 94421 20 X Court Appearance as an Expert Witness- 1/2 Day Court Appearance as an Expert Witness- 1/2 Day false false false 0 0 false 94422 20 X Court Appearance as an Expert Witness- Full Day Court Appearance as an Expert Witness- Full Day false false false 0 0 false 94423 20 X Court/Appear As Witness 3 Court/Appear As Witness 3 false false false 0 0 1919 0 MODBLIV false 94424 20 X Court/Appear As Witness 4 Court/Appear As Witness 4 false false false 0 0 1919 0 MODBLIV false 94429 20 X Court/Appear/Witness Add Court/Appear/Witness Add false false false 0 0 1919 0 MODBLIV false 95101 20 X Identification-Opinion as an Expert Assisting in Civil/ Criminal Cases Identification-Opinion as an Expert Assisting in Civil/ Criminal Cases true false false 0 0 false 95102 20 X Full/Part Time Participate in Civil Disaster Full/Part Time Participate in Civil Disaster false false false 0 0 false 95103 20 X Professional Visits Out O Professional Visits Out O false false false 0 0 1919 0 MODBLIV false 95104 20 X Written Odontology Report Written Odontology Report false false false 0 0 false 95105 20 X Post Mortem Examination O Post Mortem Examination O false false false 0 0 1919 MODBLIV false 95106 20 X Management Of Oral Diseas Management Of Oral Diseas false false false 0 0 1919 MODBLIV false 95201 20 X Indentificate Disk System Indentificate Disk System false false false 0 0 1919 0 MODBLIV false 96101 20 X Prescriptions Emergency Prescriptions Emergency false false false 0 0 false 96102 20 X Emergency Dispensing Of A Emergency Dispensing Of A false false false 0 0 1919 0 MODBLIV false 96103 20 X Dispensing,Non Emergency Dispensing,Non Emergency true false false 0 0 false 96201 20 X Intramuscular Drug Injection Intramuscular Drug Injection true false false 0 0 false 96202 20 X Intravenous Drug Injection Intravenous Drug Injection true false false 0 0 false 96203 20 X Intralesional Delivery Intralesional Delivery true false false 0 0 false 97111 20 X Bleaching, Vital, In Office- 1 Unit of Time Bleaching, Vital,In Office- 1 Unit of Time false false false 0 0 false 97112 20 X Bleaching, Vital, In Office- 2 Units of Time Bleaching, Vital,In Office- 2 Units of Time false false false 0 0 false 97113 20 X Bleaching, Vital, In Office-3Units of Time Bleaching, Vital,In Office- 3 Units of Time false false false 0 0 false 97119 20 X Bleaching, Vital, In Office- Each Add Unit over 3 Bleaching, Vital,In Office- Each Add Unit over 3 false false false 0 0 false 97121 20 X Bleaching, Vital, Home- Maxillary Arch Bleaching, Vital, Home- Maxillary Arch true true false 0 3 0011 0 false 97122 20 X Bleaching, Vital, Home- Mandibular Arch Bleaching, Vital, Home- Mandibular Arch true true false 0 3 0022 0 false 97123 20 X Bleaching, Vital, Home- Maxillary+Mandibular Bleaching, Vital, Home- Maxillary+Mandibular true true false 0 3 0000 0 false 97124 20 X Zoom 2 Bleaching false false false 0 0 false 0 97131 20 X Micro- Abrasion- 1 Unit of Time Micro- Abrasion- 1 Unit of Time false false false 0 0 false 97132 20 X Micro- Abrasion- 2 Units of Time Micro- Abrasion- 2 Units of Time false false false 0 0 false 97133 20 X Micro- Abrasion- 3 Units of Time Micro- Abrasion- 3 Units of Time false false false 0 0 false 97134 20 X Micro- Abrasion- 4 Units of Time Micro- Abrasion- 4 Units of Time false false false 0 0 false 97139 20 X Micro- Abrasion- Each Add Unit over 4 Micro- Abrasion- Each Add Unit over 4 false false false 0 0 false 98101 20 X Counselling Tobacco-use Cessation- 1 Unit of Time Counselling Tobacco-use Cessation- 1 Unit of Time true false false 0 0 false 98102 20 X Counselling Tobacco-use Cessation- 2 Units of Time Counselling Tobacco-use Cessation- 2 Units of Time true false false 0 0 false 98103 20 X Tobacco-Use Cess/Serv Add Tobacco-Use Cess/Serv Add false false false 0 0 1919 0 MODBLIV false 98109 20 X Counselling Tobacco-use Cessation- Each Add Unit over 2 Counselling Tobacco-use Cessation- Each Add Unit over 2 true false false 0 0 false 98888 20 X Lab Fee For Repair Lab Fee For Repair false false false 0 0 1919 0 MODBLIV false 99111 20 X "+L" Commercial Labratory Procedures "+L" Commercial Labratory Procedures false false false 0 0 true 99222 20 X "+L" for Oral Pathology Biopsy Services - for 30000, 40000, 70000 codes "+L" for Oral Pathology Biopsy Services - for 30000, 40000, 70000 codes false false false 0 0 true 99333 20 X "+L" In-Office Labratory Procedures "+L" In-Office Labratory Procedures false false false 0 0 true 99334 20 X Tray Tray false false false 0 0 1919 MODBLIV true 99335 20 X Bite Block Bite Block false false false 0 0 1919 MODBLIV true 99555 20 X "+E" Add Expenses of Materials "+E" Add Expenses of Materials false false false 0 0 true 99711 20 X +G.S.T. +G.S.T. false false false 0 0 false 99712 20 X +P.S.T. +P.S.T. false false false 0 0 false 99713 20 X Hst Hst false false false 0 0 1919 0 MODBLIV false DSC10 23 X Discount 10% Discount 10% false false false 0 1.0000 false 0 FB000 24 X Balance Forward Balance Forward false false false 0 0 false OB000 24 X Opening Balance Opening Balance false false false 0 0 false OC000 23 X Office Charge Office Charge false false false 0 0 false OC001 23 X Service Charge Service Charge false false false 0 0 false OC003 23 X Late Cancellation Fee Late Cancellation Fee false false false 0 1.0000 false 0 OC004 23 X No Show No Show false false false 0 1.0000 false 0 OC005 23 X Oral B Triumph Oral B Triumph false false false 0 1.0000 false 0 OCOFF 24 X Discount Discount false false false 0 0 false