14921 One unit of time

10000

PREVENTION

14000

APPLIANCES

14900

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])

14920

Appliance, Intraoral, For the Treatment of Obstructive Airway Disorders, Monitoring To include
patient to ensure proper use of appliances and evaluation for referrals to other health care
professionals for appropriate medical management.

14921 One unit of time $77.9 $77.9
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