r
00000
DIAGNOSTIC & RADIOGRAPH - XRAY
09310
Consultation
00150
Initial   Oral Examination
00210
Intra Oral Complete Series
00220
1st. Intra Oral
00230
Additional Intra Oral
00272
Two  Bitewings
00274
Four Bitewings
00321
TMJ Joint Films
00330
Panorex
00340
Cephalometric Film
00460
Pulp Vitality Test
09410
Home Visit
01110
Adult Prophylaxis
01120
Child Prophylaxis
01351
Topical Aplication of Sealants
01340
Plaque/Dental Disease Control
01330
Oral Hygiene + Toothbrus Inst.
01203
Fluoride Treatment - Child
02110
1S Amalgam - primary
02140
1S Amalgam - permanent
02120
2S Amalgam - primary
02150
2S Amalgam - permanent
02130
3S Amalgam - primary
02160
3S Amalgam - permanent
02131
4S Amalgam - primary
02161
4S Amalgam - permanent
02151
Pin Retension - per tooth
02330
1S Composite
02331
2S Composite
02332
3S Composite
02335
4S Composite, or involving incisal
04249
Crown lengthening
04210
Gingivectomy/plasty -per quadrant
04220
Gingival curettage- per quadrant
04341
Perio. scaling/root planning-quad.
04320
Provisional Splint - (intracoronal)
04321
Provisional Splint - (extracoronal)
02510
Gold Inlay - 1S
02520
Gold Inlay - 2S
02530
Gold Inlay - 3S
03110
Pulp Cap - Direct
03120
Pulp Cap - Indirect
03220
Pulpotomy
03310
Anterior Root Canal
03320
Bicuspid Root Canal
03330
Molar Root Canal
03950
Canal Prep & Fit Dowel
05110
Upper - Complete  Denture
05120
Lower - Complete  Denture
05130
Upper - Immediate Denture
05140
Lower - Immediate Denture
05210
Upper - Partial   Denture
05214
Lower - Partial   Denture
05850
Tissue conditioning - upper
05410
Adjust upper complete denture
Adjustment Complete
05411
Adjust lower complete denture
05421
Adjust upper partial
05610
Repair resin denture base
05620
Repair cast framework
05720
Rebase upper partial denture
05721
Rebase lower partial denture
05730
Reline upper denture- chairside
05731
Reline lower denture- chairside
05860
Overdenture - complete
05710
Rebase complete maxillary denture
05711
Rebase complete mandibular denture
02710
Crown - Resin
02740
Crown Porcelan
02750
Crown - Porcelain/high noble
06241
Pontic-porcelain/base metal
06210
Pontic -cast high noble
06240
Pontic-porcelain/high noble
06251
Pontic-resin/base metal
06750
Crown-Porcelain/high noble
02920
Recement Crown
06930
Recement Bridge
06950
Precision Attachment
06545
Cast Metal Retainer - Maryland Br.
02960
Labial Veneer (Laminate)
02790
Gold Crown (Full Cast)
07110
Extraction
07120
Extraction - each additional
07210
Surgical extraction -erupted tooth
07220
Impacted Tooth
07510
Incision & Drainage Abscess
09930
Post - Op Dry Socket
07310
Alveoloplasty w/extraction
09420
Hospital Call
00470
Diagnostic Casts
00490
Muscle Testing, Manual Palpat.
09950
Occlusal Analysis Mounted Case
07880
Occlusal Orthotic Device- TMJ
01510
Unilateral Space Management
01515
Bilateral  Space Management
01520
Removable Space Maintainer-Unilat
01525
Removable Space Maintainer-Bilat
00471
Diagnostic Photographs
08010
Limited Ortho. -primary
08030
Limited Ortho.-adolescent
08210
Removable appliance therapy
08220
Fixed appliance therapy
08050
Interceptive Ortho.-primary
09910
Applic. of Desensitizing Med.
09110
Palliative treatment
09210
Anesthesia
09211
Regional Block Anesthesia
06100
implant extraction
CREDT
Credit
CKRTN
Returned Check
COLLT
Collection Fee
INCOM
Incomplete Dental Plan
07431
Removal Benign Tumor >1.25mm
00140
Limited Oral Evaluation
00120
Periodic Oral Examination
BAD
Bad Account Non Payment
09430
Office visit for observation
05630
Repair broken clasp
05660
Add new clasp
ortho
04355
Full mouth debridement/perio eval
trans
77777
transfer to family accts.
porin
02610
Porcelain Inlay - 1S
02385
posterior composite-1 surf.
02386
posterior composite - 2 surf.
02387
posterior composite - 3/4 surf.
02954
prefab. post & core
01204
Fluoride Treatment - Adult
02620
Porcelain Inlay- 2S
02630
Porcelain Inlay - 3S
02104
Fluoride Treatment - adult
02751
Crown -Porcelain/base metal
02752
Crown - Porcelain/noble metal
02791
Crown - Full Cast-base metal
02792
Crown - Full Cast-noble metal
02910
Recement Inlay
02930
Prefab. S.S. Crown-primary
02931
Prefab. S.S. Crown-permanent
02932
Prefab. Resin Crown
02940
Sedative Filling
02950
Core Buildup including pins
02951
Pin Retention - per tooth
02952
Cast Post & Core,in addit. to crown
Prefab. Post & Core,in addit. to cr
02955
Post Removal
02961
Labial Veneer- resin-laboratory
02962
Labial Veneer-porcelain-laboratory
02970
Temporary Crown- fractured tooth
02980
Crown Repair
02999
Unspecified restorative procedure
03346
Retreatment of RCT- anterior
03347
Retreatment of RCT- Bicuspid
03348
Retreatment of RCT-molar
03410
Apicoectomy - anterior
03421
Apicoectomy - bicuspid
03425
Apicoectomy - molar
03426
Apicoectomy - each addit. root
03430
Retrograde Filling
03450
Root Amputation - per root
03920
Hemisection - not includ. RCT
03960
Bleaching of discolored tooth
03999
Unspecified Endodontic procedure
04211
Gingivectomy/plasty- per tooth
04240
Gingival flap - per quadrant
08040
Limited ortho - adult
08060
Interceptive Ortho.-transitional
08999
Unspecified Ortho. procedure
09440
Office visit- after hours
09630
Other medicaments - by report
09940
Occlusal Guard
09941
Fabrication of athletic mouthguard
09951
Occlusl adjustment - limited
09952
Occlusal adjustment - complete
09999
Unspecified adjunctive procedure
09970
Enamel microabrasion
06211
Pontic - cast base metal
06212
Pontic - cast noble metal
06242
Pontic - porcelain/noble
06250
Pontic - resin/high noble
06252
Pontic - resin/noble metal
06720
Crown - resin/high noble
06721
Crown - resin/base metal
06722
Crown - resin/noble metal
06751
Crown - porcelain/base metal
06752
Crown - porcelain/noble
06780
3/4 Crown -high noble
06790
Crown - full cast high noble
06791
Crown - full cast base metal
06792
Crown - full cast noble metal
06970
Cast post & core
06971
Cast post & core as part of abutmt
06975
Metal Coping
06980
Bridge repair
06999
Unspecified bridge procedure
07130
Root removal - exposed roots
07230
Removal of impacted tooth/part.bone
07250
Surgical removal of residual roots
07281
Surgical exposure to aid eruption
05211
Upper partial - resin base
05212
Lower partial - resin base
05213
Upper partial - cast base
05281
Unilateral partial
05510
Repair broken complete denture base
05520
Replace broken teeth /comp. denture
05640
Replace broken teeth/partial dent.
05650
Add tooth to partial
05740
Reline upper partial- chairside
05741
Reline lower partial - chairside
05750
Reline comp. denture - lab
05751
Reline lower denture - lab
Reline upper partial - chairside
Reline upper denture - lab
05760
Reline upper partial - lab
05761
Reline lower partial - lab
05851
Tissue conditioning - lower
05861
Overdenture - partial
05862
Precision attachment-dent. or part.
05899
Unspecified removable prosth. proc.
Adj
Adjustment to patient's acct.
02543
Onlay-metallic- 3 surfs.
06520
Inlay -bridge- 2 surfs.
Credit to patient's account
RCFee
Returned check fee
05422
Adjust partial-mandibule
REFUD
Refund-overpayment
04250
Mucogingival surgery
00270
1 bitewing x-ray
BALFD
Balance Forward