14810 Appliance, Myofascial Pain Dysfunction Syndrome, (to include: models, gnathological determinants) Appliance Construction only, and insertion adjustment (no post-insertion adjustments)

10000

PREVENTION
14000

APPLIANCES
14800

APPLIANCES, MYOFACIAL PAIN DYSFUNCTION SYNDROME
14810 Appliance, Myofascial Pain Dysfunction Syndrome, (to include: models, gnathological determinants) Appliance Construction only, and insertion adjustment (no post-insertion adjustments)
14811

Maxillary Appliance

 725.96
+Lab Costs 		725.96
+Lab Costs
14812

Mandibular Appliance

 725.96
+Lab Costs 		725.96
+Lab Costs
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