fbpx

MIDWESTERN DENTAL OF WARREN

 

Dr. MOUNIR KHARCHAF - DDS

Speciality - GP

Phone: 5867593030

$1004 - Implant Supported Retainer For Ceramic Fpd
$1006 - Abutment Supported Retainer For Porcelain Fused To Metal Fpd (High Noble Metal)
$1011 - Abutment Supported Retainer For Porcelain/Ceramic Fpd
$102 - Amalgam - Three Surfaces Primary Or Permanent
$102 - Resin-Based Composite - Two Surfaces Anterior
$102 - Therapeutic Pulpotomy (Excluding Final Restoration) - Removal Of Pulp Coronal To The Dentinocemental Junction And Application Of Medicament
$102 - repair resin partial denture base mandibular
$102 - repair resin partial denture base maxillary
$103 - Interim Caries Arresting Medicament Application
$103 - Implant Maintenance Procedures Including Removal Of Prosthesis Cleansing Of Prosthesis And Abutments And Reinsertion Of Prosthesis
$104 - House/Extended Care Facility Call
$105 - Crown Repair By Report
$105 - Inlay Repair Necessitated By Restorative Material Failure
$105 - Onlay Repair Necessitated By Restorative Material Failure
$105 - Veneer Repair Necessitated By Restorative Material Failure
$105 - Apexification/Recalcification/Pulpal Regeneration - Interim Medication Replacement (Apical Closure/Calcific Repair Of Perforations Root Resorption Pulp Space Disinfection Etc.)
$105 - Pulpal Regeneration - Interim Medication Replacement
$105 - Repair Implant Supported Prosthesis By Report
$1061 - Abutment Supported Porcelain Fused To Metal Crown (Predominantly Base Metal)
$1061 - Implant Supported Metal Crown (Titanium Titanium Alloy High Noble Metal)
$107 - Each Additional Prefabricated Post - Same Tooth
$107 - Pulpal Therapy (Resorbable Filling) - Anterior Primary Tooth (Excluding Final Restoration)
$107 - Gingivectomy Or Gingivoplasty - One To Three Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$107 - Repair And/Or Reline Of Occlusal Guard
$1082 - Abutment Supported Porcelain Fused To Metal Crown (Noble Metal)
$1082 - Abutment Supported Cast Metal Crown (High Noble Metal)
$110 - Full Mouth Debridement To Enable Comprehensive Evaluation And Diagnosis
$112 - Detailed And Extensive Oral Evaluation - Problem Focused By Report
$112 - Pulpal Debridement Primary And Permanent Teeth
$1123 - Abutment Supported Porcelain Fused To Metal Crown (High Noble Metal)
$1123 - Implant Supported Porcelain/Ceramic Crown
$1123 - Implant Supported Porcelain Fused To Metal Crown (Titanium Titanium Alloy High Noble Metal)
$113 - Pulpal Therapy (Resorbable Filling) - Posterior Primary Tooth (Excluding Final Restoration)
$114 - repair cast partial framework mandibular
$114 - repair cast partial framework maxillary
$1143 - Abutment Supported Porcelain/Ceramic Crown
$115 - Add Tooth To Existing Partial Denture
$117 - deep sedation/general anesthesia ? first 15 minutes
$117 - Deep Sedation/General Anesthesia ? Each 15 Minute Increment
$118 - Internal Root Repair Of Perforation Defects
$120 - Excision Of Pericoronal Gingiva
$121 - Alveoloplasty In Conjunction With Extractions - One To Three Teeth Or Tooth Spaces Per Quadrant
$121 - Alveoloplasty Not In Conjunction With Extractions - One To Three Teeth Or Tooth Spaces Per Quadrant
$122 - Resin-Based Composite - Two Surfaces Posterior
$124 - Resin-Based Composite - Three Surfaces Anterior
$126 - Amalgam - Four Or More Surfaces Primary Or Permanent
$130 - Bone Graft In Conjunction With Periradicular Surgery ? Each Additional Contiguous Tooth In The Same Surgical Site
$130 - Bone Replacement Graft - Each Additional Site In Quadrant
$1323 - Implant /Abutment Supported Removable Denture For Edentulous Arch ? Maxillary
$1323 - Implant /Abutment Supported Removable Denture For Edentulous Arch ? Mandibular
$1323 - Implant /Abutment Supported Removable Denture For Partially Edentulous Arch ? Maxillary
$1323 - Implant /Abutment Supported Removable Denture For Partially Edentulous Arch ? Mandibular
$133 - Repair Or Replace Broken Clasp
$134 - Each Additional Indirectly Fabricated Post - Same Tooth
$136 - Bone Graft At Time Of Implant Placement
$136 - Bone Replacement Graft For Ridge Preservation ? Per Site
$140 - Fixed Partial Denture Repair By Report
$141 - Add Clasp To Existing Partial Denture
$145 - Resin-Based Composite - Four Or More Surfaces Or Involving Incisal Angle (Anterior)
$145 - Treatment Of Root Canal Obstruction; Non-Surgical Access
$145 - Retrograde Filling - Per Root
$145 - Provisional Pontic
$151 - Resin-Based Composite - Three Surfaces Posterior
$151 - Hospital Or Ambulatory Surgical Center Call
$156 - Provisional Crown? Further Treatment Or Completion Of Diagnosis Necessary Prior To Final Impression
$156 - Distal Or Proximal Wedge Procedure (When Not Performed In Conjunction With Surgical Procedures In The Same Anatomical Area)
$156 - Provisional Implant Crown
$156 - Provisional Retainer Crown
$156 - Surgical Removal Of Erupted Tooth Requiring Removal Of Bone And/Or Sectioning Of Tooth And Including Elevation Of Mucoperiosteal Flap If Indicated
$159 - Periodontal Scaling And Root Planing - Four Or More Teeth Per Quadrant
$16 - Intraoral - Periapical First Film
$16 - Bitewing - Single Film
$164 - Resin-Based Composite Crown Anterior
$165 - Post Removal (Not In Conjunction With Endodontic Therapy)
$166 - Connector Bar
$166 - Surgical Removal Of Residual Tooth Roots (Cutting Procedure)
$174 - Alveoloplasty In Conjunction With Extractions ? Four Or More Teeth Or Tooth Spaces Per Quadrant
$175 - Reline Maxillary Partial Denture (Chairside)
$175 - Reline Mandibular Partial Denture (Chairside)
$1772 - Surgical Placement Of Implant Body: Endosteal Implant
$1772 - Surgical Placement Of Mini Implant
$178 - Prefabricated Resin Crown
$179 - Core Buildup Including Any Pins
$180 - Resin-Based Composite - Four Or More Surfaces Posterior
$180 - Alveoloplasty Not In Conjunction With Extractions ?four Or More Teeth Or Tooth Spaces Per Quadrant
$186 - Prefabricated Stainless Steel Crown - Primary Tooth
$187 - Space Maintainer - Fixed - Unilateral
$187 - Distal Shoe Space Maintainer ? Fixed ? Unilateral
$187 - Incision And Drainage Of Abscess - Intraoral Soft Tissue - Complicated (Includes Drainage Of Multiple Fascial Spaces)
$191 - Reline Complete Maxillary Denture (Chairside)
$191 - Reline Complete Mandibular Denture (Chairside)
$194 - Removal Of Impacted Tooth - Soft Tissue
$197 - Apicoectomy/Periradicular Surgery (Each Additional Root)
$20 - Local Anesthesia In Conjunction With Operative Or Surgical Procedures
$200 - Surgical Placement: Temporary Anchorage Device Without Surgical Flap
$204 - Prefabricated Porcelain/Ceramic Crown ? Primary Tooth
$204 - Prefabricated Stainless Steel Crown With Resin Window
$204 - Prefabricated Esthetic Coated Stainless Steel Crown - Primary Tooth
$2048 - Interceptive Orthodontic Treatment Of The Primary Dentition
$2048 - Interceptive Orthodontic Treatment Of The Transitional Dentition
$207 - Prefabricated Stainless Steel Crown - Permanent Tooth
$219 - Stress Breaker
$226 - Space Maintainer - Removable - Unilateral
$226 - Prefabricated Post And Core In Addition To Crown
$229 - Hemisection (Including Any Root Removal) Not Including Root Canal Therapy
$230 - Surgical Reduction Of Fibrous Tuberosity
$233 - Apexification/Recalcification/Pulpal Regeneration ? Initial Visit (Apical Closure/Calcific Repair Of Perforations Root Resorption Pulp Space Disinfection Etc.)
$233 - Pulpal Regeneration - Initial Visit
$233 - Pulpal Regeneration - Completion Of Treatment
$237 - Retainer - Cast Metal For Resin Bonded Fixed Prosthesis
$237 - Resin Retainer ? For Resin Bonded Fixed Prosthesis
$24 - Intraoral - Occlusal Film
$240 - Surgical Placement: Temporary Anchorage Device Requiring Surgical Flap
$241 - Crown - ? Resin-Based Composite (Indirect)
$245 - Gingival Flap Procedure Including Root Planing - One To Three Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$245 - Debridement Of A Periimplant Defect And Surface Cleaning Of Exposed Implant Surfaces Including Flap Entry And Closure
$25 - Extra-Oral Posterior Dental Radiographic Image
$25 - Bitewings - Two Films
$25 - Topical Application Of Fluoride
$25 - Local Anesthesia Not In Conjunction With Operative Or Surgical Procedures
$250 - Bone Graft In Conjunction With Periradicular Surgery ? Per Tooth Single Site
$250 - Bone Replacement Graft - First Site In Quadrant
$250 - Bone Graft For Repair Of Periimplant Defect ? Not Including Flap Entry And Closure Or When Indicated Placement Of A Barrier Membrane Or Biologic Materials To Aid In Osseous Regeneration
$252 - Biopsy Of Oral Tissue - Soft
$254 - space maintainer ? fixed ? bilateral maxillary
$254 - space maintainer ? fixed ? bilateral mandibular
$254 - Crown - Resin-Based Composite (Indirect)
$257 - Reline Complete Maxillary Denture (Laboratory)
$257 - Reline Complete Mandibular Denture (Laboratory)
$257 - Reline Maxillary Partial Denture (Laboratory)
$257 - Reline Mandibular Partial Denture (Laboratory)
$258 - Removal Of Impacted Tooth - Partially Bony
$259 - Guided Tissue Regeneration - Resorbable Barrier Per Site
$259 - Provisional Splinting - Extracoronal
$268 - Post And Core In Addition To Crown Indirectly Fabricated
$27 - Periodic Oral Evaluation - Established Patient
$27 - Regional Block Anesthesia
$274 - Internal Bleaching - Per Tooth
$28 - Nutritional Counseling For Control Of Dental Disease
$293 - Provisional Splinting - Intracoronal
$294 - Retainer - Porcelain/Ceramic For Resin Bonded Fixed Prosthesis
$30 - Bitewings - Three Films
$30 - Topical Fluoride Varnish; Therapeutic Application For Moderate To High Caries Risk Patients
$30 - Tobacco Counseling For The Control And Prevention Of Oral Disease
$30 - Sealant - Per Tooth
$30 - Preventive Resin Restoration In A Moderate To High Caries Risk Patient ? Permanent Tooth
$30 - Sealant Repair ? Per Tooth
$301 - Root Amputation - Per Root
$301 - Tooth Reimplantation And/Or Stabilization Of Accidentally Evulsed Or Displaced Tooth
$303 - Removal Of Impacted Tooth - Completely Bony
$303 - Coronectomy ? Intentional Partial Tooth Removal
$303 - Harvest Of Bone For Use In Autogenous Grafting Procedure
$31 - Extraoral - First Film
$31 - Therapeutic Parenteral Drug Single Administration
$310 - Apically Positioned Flap
$32 - Pulp Vitality Tests
$320 - Interim Partial Denture (Maxillary)
$326 - space maintainer ? removable ? bilateral maxillary
$326 - space maintainer ? removable ? bilateral mandibular
$326 - Incomplete Endodontic Therapy; Inoperable Unrestorable Or Fractured Tooth
$326 - Rebase Complete Mandibular Denture
$326 - Rebase Maxillary Partial Denture
$326 - Rebase Mandibular Partial Denture
$330 - Surgical Access Of An Unerupted Tooth
$337 - Interim Partial Denture (Mandibular)
$34 - Re-Evaluation - Limited Problem Focused (Established Patient; Not Post-Operative Visit)
$34 - Pulp Cap - Indirect (Excluding Final Restoration)
$340 - Frenulectomy ? Also Known As Frenectomy Or Frenotomy ? Separate Procedure Not Incidental To Another Procedure
$347 - Apexification/Recalcification - Final Visit (Includes Completed Root Canal Therapy - Apical Closure/Calcific Repair Of Perforations Root Resorption Etc.)
$347 - Rebase Complete Maxillary Denture
$347 - Excision Of Hyperplastic Tissue - Per Arch
$348 - Precision Attachment
$35 - Oral Evaluation For A Patient Under Three Years Of Age And Counseling With Primary Caregiver
$35 - Bitewings - Four Films
$35 - Inhalation Of Nitrous Oxide / Anxiolysis Analgesia
$350 - Inlay - Resin-Based Composite - One Surface
$350 - External Bleaching - Per Arch
$358 - Orthodontic Retention (Removal Of Appliances Construction And Placement Of Retainer(S))
$361 - Gingivectomy Or Gingivoplasty - Four Or More Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$368 - Prefabricated Abutment - Includes Placement
$368 - Frenuloplasty
$369 - Onlay - Resin-Based Composite - Two Surfaces
$37 - Pin Retention - Per Tooth In Addition To Restoration
$371 - Guided Tissue Regeneration - Nonresorbable Barrier Per Site (Includes Membrane Removal)
$38 - Oral Hygiene Instructions
$381 - Removal Of Impacted Tooth - Completely Bony With Unusual Surgical Complications
$385 - Surgical Placement: Temporary Anchorage Device [screw Retained Plate] Requiring Surgical Flap
$389 - Removable Appliance Therapy
$389 - Fixed Appliance Therapy
$39 - Prophylaxis - Child
$39 - Re-Cementation Of Space Maintainer
$391 - Osseous Surgery (Including Flap Entry And Closure) - One To Three Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$391 - Debridement And Osseous Contouring Of A Periimplant Defect; Includes Surface Cleaning Of Exposed Implant Surfaces And Flap Entry And Closure
$4097 - Comprehensive Orthodontic Treatment Of The Transitional Dentition
$4097 - Comprehensive Orthodontic Treatment Of The Adolescent Dentition
$4097 - Comprehensive Orthodontic Treatment Of The Adult Dentition
$41 - Oral/Facial Photographic Images
$41 - Pulp Cap - Direct (Excluding Final Restoration)
$413 - Inlay - Metallic - One Surface
$413 - Interim Complete Denture (Maxillary)
$413 - Occlusal Adjustment - Complete
$417 - Inlay - Resin-Based Composite - Two Surfaces
$421 - Gingival Flap Procedure Including Root Planing - Four Or More Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$424 - Onlay - Resin-Based Composite - Three Surfaces
$424 - Endodontic Therapy Anterior Tooth (Excluding Final Restoration)
$43 - Office Visit For Observation (During Regularly Scheduled Hours) - No Other Services Performed
$435 - Interim Complete Denture (Mandibular)
$438 - Inlay - Resin-Based Composite - Three Or More Surfaces
$453 - Replace All Teeth And Acrylic On Cast Metal Framework (Maxillary)
$453 - Replace All Teeth And Acrylic On Cast Metal Framework (Mandibular)
$453 - occlusal guard ? hard appliance full arch
$453 - occlusal guard ? soft appliance full arch
$453 - occlusal guard ? hard appliance partial arch
$455 - Semi-Precision Attachment Abutment
$455 - Custom Abutment - Includes Placement
$456 - Onlay - Resin-Based Composite - Four Or More Surfaces
$46 - Therapeutic Parenteral Drugs Two Or More Administrations Different Medications
$462 - Clinical Crown Lengthening - Hard Tissue
$462 - Occlusal Orthotic Device By Report
$463 - Apicoectomy/Periradicular Surgery - Anterior
$463 - Periradicular Surgery Without Apicoectomy
$470 - Inlay - Cast Predominantly Base Metal Two Surfaces
$473 - Limited Orthodontic Treatment Of The Primary Dentition
$473 - Limited Orthodontic Treatment Of The Transitional Dentition
$473 - Limited Orthodontic Treatment Of The Adolescent Dentition
$473 - Limited Orthodontic Treatment Of The Adult Dentition
$476 - Sinus Augmentation Via A Vertical Approach
$477 - Inlay - Cast Noble Metal Two Surfaces
$478 - Inlay - Metallic - Two Surfaces
$478 - Inlay - Porcelain/Ceramic - One Surface
$48 - Limited Oral Evaluation - Problem Focused
$48 - Comprehensive Oral Evaluation - New Or Established Patient
$48 - Adjust Complete Denture - Maxillary
$48 - Adjust Complete Denture - Mandibular
$48 - Adjust Partial Denture - Maxillary
$48 - Adjust Partial Denture - Mandibular
$48 - Occlusal Orthotic Device Adjustment
$48 - Pre-Orthodontic Treatment Visit
$48 - Removable Orthodontic Retainer Adjustment
$48 - Evaluation For Deep Sedation Or General Anesthesia
$48 - Occlusal Guard Adjustment
$483 - Inlay - Porcelain/Ceramic Two Surfaces
$487 - Inlay - Cast High Noble Metal Two Surfaces
$499 - Pedicle Soft Tissue Graft Procedure
$50 - Removal Of Fixed Space Maintainer
$50 - remove broken implant retaining screw
$504 - Inlay - Titanium
$511 - Inlay - Porcelain/Ceramic - Two Surfaces
$511 - Endodontic Therapy Bicuspid Tooth (Excluding Final Restoration)
$511 - Free Soft Tissue Graft Procedure (Including Donor Site Surgery) First Tooth Or Edentulous Tooth Position In Graft
$511 - Free Soft Tissue Graft Procedure (Including Donor Site Surgery) Each Additional Contiguous Tooth Or Edentulous Tooth Position In Same Graft Site
$515 - Apicoectomy/Periradicular Surgery - Bicuspid (First Root)
$515 - Soft Tissue Allograft
$515 - Non-Autogenous Connective Tissue Graft Procedure (Including Recipient Surgical Site And Donor Material) ? Each Additional Contiguous Tooth Implant Or Edentulous Tooth Position In Same Graft Site
$515 - Inlay - Porcelain/Ceramic Three Or More Surfaces
$515 - Onlay -Porcelain/Ceramic Two Surfaces
$52 - Comprehensive Periodontal Evaluation - New Or Established Patient
$523 - Onlay - Cast Predominantly Base Metal Two Surfaces
$525 - Inlay - Cast Predominantly Base Metal Three Or More Surfaces
$53 - Prophylaxis - Adult
$53 - Cleaning And Inspection Of Removable Complete Denture Maxillary
$53 - Cleaning And Inspection Of Removable Complete Denture Mandibular
$53 - Cleaning And Inspection Of Removable Partial Denture Maxillary
$53 - Cleaning And Inspection Of Removable Partial Denture Mandibular
$532 - Connecting Bar ? Implant Supported Or Abutment Supported
$533 - Onlay - Metallic-Two Surfaces
$533 - Onlay - Porcelain/Ceramic - Two Surfaces
$533 - Removal Of Lateral Exostosis (Maxilla Or Mandible)
$535 - Onlay - Cast Noble Metal Two Surfaces
$536 - Onlay - Titanium
$537 - Onlay - Cast High Noble Metal Two Surfaces
$539 - Inlay - Cast Noble Metal Three Or More Surfaces
$543 - Inlay - Metallic - Three Or More Surfaces
$543 - Inlay - Porcelain/Ceramic - Three Or More Surfaces
$543 - Pontic - Porcelain Fused To Predominantly Base Metal
$543 - Inlay - Cast High Noble Metal Three Or More Surfaces
$546 - Labial Veneer (Resin Laminate) - Chairside
$546 - Onlay - Porcelain/Ceramic Three Or More Surfaces
$549 - Onlay - Cast Noble Metal Three Or More Surfaces
$55 - Vertical Bitewings - 7 To 8 Films
$551 - removable unilateral partial denture ? one piece cast metal (including clasps and teeth) maxillary
$551 - removable unilateral partial denture ? one piece cast metal (including clasps and teeth) mandibular
$56 - Enamel Microabrasion
$56 - External Bleaching - Per Tooth
$565 - Onlay - Metallic-Three Surfaces
$565 - Subepithelial Connective Tissue Graft Procedures Per Tooth
$565 - Autogenous Connective Tissue Graft Procedure (Including Donor And Recipient Surgical Sites) ? Each Additional Contiguous Tooth Implant Or Edentulous Tooth Position In Same Graft Site
$565 - Pontic - Cast Predominantly Base Metal
$565 - Pontic - Porcelain Fused To Noble Metal
$567 - Pontic - Indirect Resin Based Composite
$567 - Onlay - Cast Predominantly Base Metal Three Or More Surfaces
$570 - Crown - 3/4 Cast Predominantly Base Metal
$576 - Retreatment Of Previous Root Canal Therapy - Anterior
$576 - Pontic - Cast Noble Metal
$578 - Crown - Indirect Resin Based Composite
$587 - Onlay - Metallic-Four Or More Surfaces
$587 - Onlay - Porcelain/Ceramic - Three Surfaces
$587 - Onlay - Cast High Noble Metal Three Or More Surfaces
$588 - Crown - 3/4 Cast Noble Metal
$588 - Apicoectomy/Periradicular Surgery - Molar (First Root)
$590 - Crown - Full Cast Predominantly Base Metal
$596 - Surgical Reduction Of Osseous Tuberosity
$598 - Pontic - Cast High Noble Metal
$60 - Non-Intravenous Conscious Sedation
$601 - Crown - Porcelain Fused To Predominantly Base Metal
$605 - Crown - 3/4 Cast High Noble Metal
$609 - Crown - Full Cast Noble Metal
$609 - Biopsy Of Oral Tissue - Hard (Bone Tooth)
$611 - Crown - Titanium
$614 - Labial Veneer (Resin Laminate) - Laboratory
$616 - Crown - Porcelain Fused To Noble Metal
$620 - Onlay - Porcelain/Ceramic - Four Or More Surfaces
$620 - Pontic - Porcelain Fused To High Noble Metal
$622 - Crown - Full Cast High Noble Metal
$626 - Crown - 3/4 Porcelain/Ceramic
$63 - Localized Delivery Of Antimicrobial Agents Via A Controlled Release Vehicle Into Diseased Crevicular Tissue Per Tooth By Report
$630 - Pontic - Titanium
$64 - Amalgam - One Surface Primary Or Permanent
$64 - Extraction Coronal Remnants - Deciduous Tooth
$64 - Palliative (Emergency) Treatment Of Dental Pain - Minor Procedure
$651 - Crown - Porcelain Fused To High Noble Metal
$652 - Pontic - Porcelain/Ceramic
$657 - Crown - Porcelain/Ceramic Substrate
$657 - Endodontic Therapy Molar (Excluding Final Restoration)
$662 - Crown - Porcelain/Ceramic
$668 - Removal Of Torus Mandibularis
$67 - Recement Inlay Onlay Or Partial Coverage Restoration
$67 - Recement Cast Or Prefabricated Post And Core
$67 - Recement Crown
$674 - Retreatment Of Previous Root Canal Therapy - Bicuspid
$674 - Combined Connective Tissue And Double Pedicle Graft Per Tooth
$68 - Diagnostic Casts
$685 - Osseous Surgery (Including Flap Entry And Closure) - Four Or More Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$691 - Labial Veneer (Porcelain Laminate) - Laboratory
$693 - Overdenture ? Partial Maxillary
$693 - Overdenture ? Partial Mandibular
$700 - Pediatric Partial Denture Fixed
$704 - Overdenture ? Complete Maxillary
$704 - Overdenture ? Complete Mandibular
$708 - Removal Of Torus Palatinus
$71 - Protective Restoration
$71 - Interim Therapeutic Restoration ? Primary Dentition
$71 - Additional Procedures To Construct New Crown Under Existing Partial Denture Framework
$71 - Fixed Partial Denture Sectioning
$717 - Maxillary Partial Denture - Resin Base (Including Any Conventional Clasps Rests And Teeth)
$717 - Immediate Maxillary Partial Denture ? Resin Base (Including Any Conventional Clasps Rests And Teeth)
$74 - Odontoplasty 1 - 2 Teeth; Includes Removal Of Enamel Projections
$75 - Brush Biopsy - Transepithelial Sample Collection
$76 - Panoramic Film
$76 - Office Visit - After Regularly Scheduled Hours
$79 - Resin-Based Composite - One Surface Anterior
$79 - Reattachment Of Tooth Fragment Incisal Edge Or Cusp
$79 - Replace Missing Or Broken Teeth - Complete Denture (Each Tooth)
$79 - Recement Fixed Partial Denture
$79 - Exfoliative Cytological Sample Collection
$79 - Repair Of Orthodontic Appliance
$80 - Recement Implant/Abutment Supported Crown
$804 - Retreatment Of Previous Root Canal Therapy - Molar
$82 - Intraoral - Complete Series (Including Bitewings)
$82 - Tissue Conditioning Maxillary
$82 - Tissue Conditioning Mandibular
$82 - Occlusal Adjustment - Limited
$821 - Incision And Drainage Of Abscess - Extraoral Soft Tissue
$823 - Abutment Supported Retainer Crown For Fpd - (Titanium)
$837 - Mandibular Partial Denture - Resin Base (Including Any Conventional Clasps Rests And Teeth)
$837 - Immediate Mandibular Partial Denture ? Resin Base (Including Any Conventional Clasps Rests And Teeth)
$84 - Extraction Erupted Tooth Or Exposed Root (Elevation And/Or Forceps Removal)
$85 - Amalgam - Two Surfaces Primary Or Permanent
$85 - Replace Broken Teeth - Per Tooth
$861 - Complete Denture - Maxillary
$861 - Complete Denture - Mandibular
$87 - Replacement Of Semi-Precision Or Precision Attachment (Male Or Female Component) Of Implant/Abutment Supported Prosthesis Per Attachment
$87 - Recement Implant/Abutment Supported Fixed Partial Denture
$87 - intravenous moderate (conscious) sedation/analgesia- first 15 minutes
$87 - Intravenous Moderate (Conscious) Sedation/Analgesia ? Each 15 Minute Increment
$896 - Abutment Supported Crown - (Titanium)
$897 - Abutment Supported Retainer For Cast Metal Fpd (Predominantly Base Metal)
$9 - Intraoral - Periapical Each Additional Film
$90 - Resin-Based Composite - One Surface Posterior
$90 - Incision And Drainage Of Abscess - Intraoral Soft Tissue
$902 - Incision And Drainage Of Abscess - Extraoral Soft Tissue - Complicated (Includes Drainage Of Multiple Fascial Spaces)
$92 - Periodontal Scaling And Root Planing - One To Three Teeth Per Quadrant
$92 - Scaling And Debridement In The Presence Of Inflammation Or Mucositis Of A Single Implant Including Cleaning Of The Implant Surfaces Without Flap Entry And Closure
$924 - Immediate Denture - Maxillary
$924 - Immediate Denture - Mandibular
$927 - Abutment Supported Cast Metal Crown (Predominantly Base Metal)
$93 - Cephalometric Film
$93 - Interpretation Of Diagnostic Image By A Practitioner Not Associated With Capture Of The Image Including Report
$93 - Consultation - Diagnostic Service Provided By Dentist Or Physician Other Than Requesting Dentist Or Physician
$935 - Maxillary Partial Denture - Cast Metal Framework With Resin Denture Bases (Including Any Conventional Clasps Rests And Teeth)
$935 - Mandibular Partial Denture - Cast Metal Framework With Resin Denture Bases (Including Any Conventional Clasps Rests And Teeth)
$935 - Immediate Maxillary Partial Denture ? Cast Metal Framework With Resin Denture Bases (Including Any Conventional Clasps Rests And Teeth)
$935 - Immediate Mandibular Partial Denture ? Cast Metal Framework With Resin Denture Bases (Including Any Conventional Clasps Rests And Teeth)
$937 - Maxillary Partial Denture - Flexible Base (Including Any Clasps Rests And Teeth)
$937 - Mandibular Partial Denture - Flexible Base (Including Any Clasps Rests And Teeth)
$948 - Implant Supported Retainer For Cast Metal Fpd (Titanium Titanium Alloy Or High Noble Metal)
$95 - repair broken complete denture base mandibular
$95 - repair broken complete denture base maxillary
$951 - Abutment Supported Retainer For Porcelain Fused To Metal Fpd (Predominantly Base Metal)
$953 - Abutment Supported Retainer For Cast Metal Fpd (Noble Metal)
$971 - Abutment Supported Retainer For Porcelain Fused To Metal Fpd (Noble Metal)
$977 - Implant Supported Retainer For Porcelain Fused To Metal Fpd (Titanium Titanium Alloy Or High Noble Metal)
$979 - Abutment Supported Cast Metal Crown (Noble Metal)
$982 - Abutment Supported Retainer For Cast Metal Fpd (High Noble Metal)
$99 - Scaling In Presence Of Generalized Moderate Or Severe Gingival Inflammation ? Full Mouth After Oral Evaluation
$99 - Periodontal Maintenance
7591 NINE MILE ROAD WARREN MI 48091