04710 Equilibration, Casts Diagnostic (Pilot Equilibration) For Extensive Or Complicated Restorative Dentistry
| 00000 | DIAGNOSTIC |
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| 04000 | TEST/ANALYSIS/LABORATORY PROCEDURES/INTERPRETATION AND/OR REPORTS |
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| 04700 | SUPPLEMENTARY DIAGNOSTIC PROCEDURES (INTERPRETATION ONLY) |
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| 04710 | Equilibration, Casts Diagnostic (Pilot Equilibration) For Extensive Or Complicated Restorative Dentistry | ||
| 04711 | One unit of time |
77.9
+Lab Costs |
77.9
+Lab Costs |
| 04712 | Two units |
155.8
+Lab Costs |
155.8
+Lab Costs |
| 04713 | Three units |
233.72
+Lab Costs |
233.72
+Lab Costs |
| 04714 | Four units |
311.62
+Lab Costs |
311.62
+Lab Costs |
| 04719 | Each additional unit over four |
77.9
+Lab Costs |
77.9
+Lab Costs |