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
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