14711 Maxillary Appliance

10000	PREVENTION
14000	APPLIANCES
14700	APPLIANCES, TEMPOROMANDIBULAR JOINT
14710	Appliance, TMJ, Diagnostic and/or Therapeutic, includes impression, insertion and insertion adjustment (no post-insertion adjustments)
14711	Maxillary Appliance	$643.26 +Lab Costs	$643.26 +Lab Costs