14919 Each additional unit over two

PREVENTION

APPLIANCES

APPLIANCES, INTRAORAL, TO TREAT MEDICALLY DIAGNOSED OBSTRUCTIVE SLEEP APNEA,
SNORING, UPPER AIRWAY RESISTANCE SYNDROM (UARS) WITH OR WITHOUT APNEA (Includes
models, gnathological determinants, appliance construction and insertion adjustment [no post-
insertion adjustments])

Appliance, Intraoral, For the Treatment of Obstructive Airway Disorders, Periodic Maintenance,
Adjustment and Repairs