14820 Appliance, Myofacial Pain Dysfunction Syndrome, Periodic Maintenance, Adjustment and Repairs
| 10000 | PREVENTION |
||
| 14000 | APPLIANCES |
||
| 14800 | APPLIANCES, MYOFACIAL PAIN DYSFUNCTION SYNDROME |
||
| 14820 | Appliance, Myofacial Pain Dysfunction Syndrome, Periodic Maintenance, Adjustment and Repairs | ||
| 14821 | One unit of time |
83.42
+Lab Costs |
83.42
+Lab Costs |
| 14822 | Two units |
166.84
+Lab Costs |
166.84
+Lab Costs |
| 14823 | Three units |
250.28
+Lab Costs |
250.28
+Lab Costs |
| 14829 | Each additional unit over three |
83.42
+Lab Costs |
83.42
+Lab Costs |