04720 Wax-up, Diagnostic (To Evaluate Cosmetic And/Or Preparation Design And/Or Occlusal Considerations) (Gnathological Wax-up)
| 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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| 04720 | Wax-up, Diagnostic (To Evaluate Cosmetic And/Or Preparation Design And/Or Occlusal Considerations) (Gnathological Wax-up) | ||
| 04721 | One unit of time |
77.9
+Lab Costs |
77.9
+Lab Costs |
| 04722 | Two units |
155.8
+Lab Costs |
155.8
+Lab Costs |
| 04723 | Three units |
233.72
+Lab Costs |
233.72
+Lab Costs |
| 04724 | Four units |
311.62
+Lab Costs |
311.62
+Lab Costs |
| 04729 | Each additional unit over four |
77.9
+Lab Costs |
77.9
+Lab Costs |