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NELA DENTAL OF MONROE

 

Dr. ROBERT COSTELLO - DDS

Speciality - GP

Phone: 3183875732

$100 - Apexification/Recalcification/Pulpal Regeneration - Interim Medication Replacement (Apical Closure/Calcific Repair Of Perforations Root Resorption Pulp Space Disinfection Etc.)
$100 - Pulpal Regeneration - Interim Medication Replacement
$101 - Interpretation Of Diagnostic Image By A Practitioner Not Associated With Capture Of The Image Including Report
$101 - Resin-Based Composite - Two Surfaces Anterior
$101 - Consultation - Diagnostic Service Provided By Dentist Or Physician Other Than Requesting Dentist Or Physician
$104 - Add Tooth To Existing Partial Denture
$104 - deep sedation/general anesthesia ? first 15 minutes
$104 - Deep Sedation/General Anesthesia ? Each 15 Minute Increment
$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 - Repair Implant Supported Prosthesis By Report
$106 - Amalgam - Three Surfaces Primary Or Permanent
$106 - Pulpal Therapy (Resorbable Filling) - Anterior Primary Tooth (Excluding Final Restoration)
$108 - Pulpal Debridement Primary And Permanent Teeth
$111 - Each Additional Indirectly Fabricated Post - Same Tooth
$111 - Excision Of Pericoronal Gingiva
$112 - Detailed And Extensive Oral Evaluation - Problem Focused By Report
$114 - Pulpal Therapy (Resorbable Filling) - Posterior Primary Tooth (Excluding Final Restoration)
$114 - repair cast partial framework mandibular
$114 - repair cast partial framework maxillary
$115 - Alveoloplasty In Conjunction With Extractions - One To Three Teeth Or Tooth Spaces Per Quadrant
$117 - Repair Or Replace Broken Clasp
$12 - Intraoral - Periapical Each Additional Film
$120 - Bone Graft In Conjunction With Periradicular Surgery ? Each Additional Contiguous Tooth In The Same Surgical Site
$120 - Bone Replacement Graft - Each Additional Site In Quadrant
$121 - Resin-Based Composite - Two Surfaces Posterior
$124 - Resin-Based Composite - Three Surfaces Anterior
$124 - Add Clasp To Existing Partial Denture
$124 - Repair And/Or Reline Of Occlusal Guard
$125 - Bone Graft At Time Of Implant Placement
$125 - Bone Replacement Graft For Ridge Preservation ? Per Site
$126 - Internal Root Repair Of Perforation Defects
$127 - Connector Bar
$129 - House/Extended Care Facility Call
$1292 - Implant /Abutment Supported Removable Denture For Edentulous Arch ? Maxillary
$1292 - Implant /Abutment Supported Removable Denture For Edentulous Arch ? Mandibular
$1292 - Implant /Abutment Supported Removable Denture For Partially Edentulous Arch ? Maxillary
$1292 - Implant /Abutment Supported Removable Denture For Partially Edentulous Arch ? Mandibular
$131 - Amalgam - Four Or More Surfaces Primary Or Permanent
$134 - Gingivectomy Or Gingivoplasty - One To Three Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$134 - Periodontal Scaling And Root Planing - Four Or More Teeth Per Quadrant
$136 - Post Removal (Not In Conjunction With Endodontic Therapy)
$139 - Core Buildup Including Any Pins
$14 - Intraoral - Periapical First Film
$140 - Surgical Removal Of Erupted Tooth Requiring Removal Of Bone And/Or Sectioning Of Tooth And Including Elevation Of Mucoperiosteal Flap If Indicated
$142 - Resin-Based Composite - Four Or More Surfaces Or Involving Incisal Angle (Anterior)
$142 - Retrograde Filling - Per Root
$143 - Treatment Of Root Canal Obstruction; Non-Surgical Access
$147 - Prefabricated Stainless Steel Crown - Primary Tooth
$15 - Bitewing - Single Film
$150 - Fixed Partial Denture Repair By Report
$151 - Resin-Based Composite - Three Surfaces Posterior
$154 - Surgical Removal Of Residual Tooth Roots (Cutting Procedure)
$159 - Reline Maxillary Partial Denture (Chairside)
$159 - Reline Mandibular Partial Denture (Chairside)
$162 - Resin-Based Composite Crown Anterior
$164 - Alveoloplasty In Conjunction With Extractions ? Four Or More Teeth Or Tooth Spaces Per Quadrant
$168 - Prefabricated Stainless Steel Crown - Permanent Tooth
$168 - Stress Breaker
$170 - Removal Of Impacted Tooth - Soft Tissue
$173 - Reline Complete Maxillary Denture (Chairside)
$173 - Reline Complete Mandibular Denture (Chairside)
$1730 - Surgical Placement Of Implant Body: Endosteal Implant
$1730 - Surgical Placement Of Mini Implant
$174 - Distal Or Proximal Wedge Procedure (When Not Performed In Conjunction With Surgical Procedures In The Same Anatomical Area)
$176 - Prefabricated Post And Core In Addition To Crown
$176 - Incision And Drainage Of Abscess - Intraoral Soft Tissue - Complicated (Includes Drainage Of Multiple Fascial Spaces)
$176 - Hospital Or Ambulatory Surgical Center Call
$18 - Local Anesthesia In Conjunction With Operative Or Surgical Procedures
$184 - Resin-Based Composite - Four Or More Surfaces Posterior
$185 - Surgical Placement: Temporary Anchorage Device Without Surgical Flap
$19 - Topical Application Of Fluoride
$190 - Space Maintainer - Fixed - Unilateral
$190 - Distal Shoe Space Maintainer ? Fixed ? Unilateral
$194 - Apicoectomy/Periradicular Surgery (Each Additional Root)
$205 - Alveoloplasty Not In Conjunction With Extractions - One To Three Teeth Or Tooth Spaces Per Quadrant
$207 - Prefabricated Resin Crown
$2153 - Interceptive Orthodontic Treatment Of The Primary Dentition
$2153 - Interceptive Orthodontic Treatment Of The Transitional Dentition
$22 - Local Anesthesia Not In Conjunction With Operative Or Surgical Procedures
$220 - Provisional Splinting - Extracoronal
$221 - Post And Core In Addition To Crown Indirectly Fabricated
$221 - Surgical Placement: Temporary Anchorage Device Requiring Surgical Flap
$226 - Hemisection (Including Any Root Removal) Not Including Root Canal Therapy
$228 - Reline Maxillary Partial Denture (Laboratory)
$228 - Reline Mandibular Partial Denture (Laboratory)
$23 - Intraoral - Occlusal Film
$23 - Extra-Oral Posterior Dental Radiographic Image
$23 - Bitewings - Two Films
$231 - Reline Complete Maxillary Denture (Laboratory)
$231 - Reline Complete Mandibular Denture (Laboratory)
$232 - Provisional Crown? Further Treatment Or Completion Of Diagnosis Necessary Prior To Final Impression
$232 - Provisional Implant Crown
$232 - Provisional Pontic
$232 - Provisional Retainer Crown
$234 - Space Maintainer - Removable - Unilateral
$236 - Apexification/Recalcification/Pulpal Regeneration ? Initial Visit (Apical Closure/Calcific Repair Of Perforations Root Resorption Pulp Space Disinfection Etc.)
$236 - Pulpal Regeneration - Initial Visit
$236 - Pulpal Regeneration - Completion Of Treatment
$237 - Prefabricated Porcelain/Ceramic Crown ? Primary Tooth
$237 - Prefabricated Stainless Steel Crown With Resin Window
$237 - Prefabricated Esthetic Coated Stainless Steel Crown - Primary Tooth
$237 - Removal Of Impacted Tooth - Partially Bony
$239 - Bone Graft In Conjunction With Periradicular Surgery ? Per Tooth Single Site
$239 - Bone Replacement Graft - First Site In Quadrant
$239 - 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
$248 - Retainer - Cast Metal For Resin Bonded Fixed Prosthesis
$248 - Resin Retainer ? For Resin Bonded Fixed Prosthesis
$248 - Biopsy Of Oral Tissue - Soft
$25 - Periodic Oral Evaluation - Established Patient
$25 - Regional Block Anesthesia
$251 - Provisional Splinting - Intracoronal
$258 - Guided Tissue Regeneration - Resorbable Barrier Per Site
$26 - Nutritional Counseling For Control Of Dental Disease
$260 - space maintainer ? fixed ? bilateral maxillary
$260 - space maintainer ? fixed ? bilateral mandibular
$262 - Crown - Resin-Based Composite (Indirect)
$262 - Crown - ? Resin-Based Composite (Indirect)
$268 - Gingival Flap Procedure Including Root Planing - One To Three Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$268 - Debridement Of A Periimplant Defect And Surface Cleaning Of Exposed Implant Surfaces Including Flap Entry And Closure
$268 - Surgical Reduction Of Fibrous Tuberosity
$274 - Internal Bleaching - Per Tooth
$277 - Tooth Reimplantation And/Or Stabilization Of Accidentally Evulsed Or Displaced Tooth
$279 - Removal Of Impacted Tooth - Completely Bony
$279 - Coronectomy ? Intentional Partial Tooth Removal
$279 - Harvest Of Bone For Use In Autogenous Grafting Procedure
$28 - Extraoral - First Film
$28 - Pulp Vitality Tests
$28 - Tobacco Counseling For The Control And Prevention Of Oral Disease
$283 - Interim Partial Denture (Maxillary)
$29 - Oral Evaluation For A Patient Under Three Years Of Age And Counseling With Primary Caregiver
$29 - Bitewings - Three Films
$29 - Topical Fluoride Varnish; Therapeutic Application For Moderate To High Caries Risk Patients
$290 - Rebase Maxillary Partial Denture
$290 - Rebase Mandibular Partial Denture
$292 - Root Amputation - Per Root
$293 - Rebase Complete Mandibular Denture
$299 - Interim Partial Denture (Mandibular)
$299 - Retainer - Porcelain/Ceramic For Resin Bonded Fixed Prosthesis
$30 - Sealant - Per Tooth
$30 - Preventive Resin Restoration In A Moderate To High Caries Risk Patient ? Permanent Tooth
$30 - Sealant Repair ? Per Tooth
$307 - Rebase Complete Maxillary Denture
$309 - Alveoloplasty Not In Conjunction With Extractions ?four Or More Teeth Or Tooth Spaces Per Quadrant
$31 - Re-Evaluation - Limited Problem Focused (Established Patient; Not Post-Operative Visit)
$31 - Inhalation Of Nitrous Oxide / Anxiolysis Analgesia
$31 - Therapeutic Parenteral Drug Single Administration
$315 - Orthodontic Retention (Removal Of Appliances Construction And Placement Of Retainer(S))
$319 - Apically Positioned Flap
$319 - Surgical Access Of An Unerupted Tooth
$32 - Pin Retention - Per Tooth In Addition To Restoration
$326 - space maintainer ? removable ? bilateral maxillary
$326 - space maintainer ? removable ? bilateral mandibular
$33 - Pulp Cap - Indirect (Excluding Final Restoration)
$330 - Frenulectomy ? Also Known As Frenectomy Or Frenotomy ? Separate Procedure Not Incidental To Another Procedure
$333 - Excision Of Hyperplastic Tissue - Per Arch
$336 - Precision Attachment
$34 - Bitewings - Four Films
$34 - Oral/Facial Photographic Images
$340 - Incomplete Endodontic Therapy; Inoperable Unrestorable Or Fractured Tooth
$347 - Apexification/Recalcification - Final Visit (Includes Completed Root Canal Therapy - Apical Closure/Calcific Repair Of Perforations Root Resorption Etc.)
$347 - Frenuloplasty
$35 - Oral Hygiene Instructions
$350 - Guided Tissue Regeneration - Nonresorbable Barrier Per Site (Includes Membrane Removal)
$350 - External Bleaching - Per Arch
$351 - Removal Of Impacted Tooth - Completely Bony With Unusual Surgical Complications
$354 - Surgical Placement: Temporary Anchorage Device [screw Retained Plate] Requiring Surgical Flap
$359 - Prefabricated Abutment - Includes Placement
$36 - Prophylaxis - Child
$366 - Interim Complete Denture (Maxillary)
$371 - Gingivectomy Or Gingivoplasty - Four Or More Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$38 - Limited Oral Evaluation - Problem Focused
$38 - Pre-Orthodontic Treatment Visit
$38 - Evaluation For Deep Sedation Or General Anesthesia
$38 - Office Visit For Observation (During Regularly Scheduled Hours) - No Other Services Performed
$381 - Osseous Surgery (Including Flap Entry And Closure) - One To Three Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$381 - Debridement And Osseous Contouring Of A Periimplant Defect; Includes Surface Cleaning Of Exposed Implant Surfaces And Flap Entry And Closure
$394 - Interim Complete Denture (Mandibular)
$395 - Occlusal Adjustment - Complete
$402 - Inlay - Resin-Based Composite - One Surface
$402 - Onlay - Resin-Based Composite - Two Surfaces
$402 - occlusal guard ? hard appliance full arch
$402 - occlusal guard ? soft appliance full arch
$402 - occlusal guard ? hard appliance partial arch
$41 - Comprehensive Oral Evaluation - New Or Established Patient
$410 - Occlusal Orthotic Device By Report
$410 - Removable Appliance Therapy
$410 - Fixed Appliance Therapy
$412 - Replace All Teeth And Acrylic On Cast Metal Framework (Maxillary)
$412 - Replace All Teeth And Acrylic On Cast Metal Framework (Mandibular)
$413 - Endodontic Therapy Anterior Tooth (Excluding Final Restoration)
$42 - Re-Cementation Of Space Maintainer
$42 - Pulp Cap - Direct (Excluding Final Restoration)
$43 - Adjust Complete Denture - Maxillary
$43 - Adjust Complete Denture - Mandibular
$43 - Adjust Partial Denture - Maxillary
$43 - Adjust Partial Denture - Mandibular
$43 - Occlusal Orthotic Device Adjustment
$43 - Removable Orthodontic Retainer Adjustment
$43 - Occlusal Guard Adjustment
$4307 - Comprehensive Orthodontic Treatment Of The Transitional Dentition
$4307 - Comprehensive Orthodontic Treatment Of The Adolescent Dentition
$4307 - Comprehensive Orthodontic Treatment Of The Adult Dentition
$438 - Labial Veneer (Resin Laminate) - Chairside
$438 - Sinus Augmentation Via A Vertical Approach
$443 - Gingival Flap Procedure Including Root Planing - Four Or More Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$444 - Semi-Precision Attachment Abutment
$444 - Custom Abutment - Includes Placement
$449 - Inlay - Metallic - One Surface
$46 - Comprehensive Periodontal Evaluation - New Or Established Patient
$46 - Therapeutic Parenteral Drugs Two Or More Administrations Different Medications
$462 - Clinical Crown Lengthening - Hard Tissue
$473 - Apicoectomy/Periradicular Surgery - Anterior
$473 - Periradicular Surgery Without Apicoectomy
$474 - Inlay - Resin-Based Composite - Two Surfaces
$474 - Onlay - Resin-Based Composite - Three Surfaces
$485 - Inlay - Cast Predominantly Base Metal Two Surfaces
$488 - removable unilateral partial denture ? one piece cast metal (including clasps and teeth) maxillary
$488 - removable unilateral partial denture ? one piece cast metal (including clasps and teeth) mandibular
$49 - Prophylaxis - Adult
$49 - Cleaning And Inspection Of Removable Complete Denture Maxillary
$49 - Cleaning And Inspection Of Removable Complete Denture Mandibular
$49 - Cleaning And Inspection Of Removable Partial Denture Maxillary
$49 - Cleaning And Inspection Of Removable Partial Denture Mandibular
$490 - Endodontic Therapy Bicuspid Tooth (Excluding Final Restoration)
$493 - Inlay - Cast Noble Metal Two Surfaces
$494 - Labial Veneer (Resin Laminate) - Laboratory
$50 - Vertical Bitewings - 7 To 8 Films
$50 - remove broken implant retaining screw
$503 - Inlay - Cast High Noble Metal Two Surfaces
$504 - Limited Orthodontic Treatment Of The Primary Dentition
$504 - Limited Orthodontic Treatment Of The Transitional Dentition
$504 - Limited Orthodontic Treatment Of The Adolescent Dentition
$504 - Limited Orthodontic Treatment Of The Adult Dentition
$505 - Inlay - Resin-Based Composite - Three Or More Surfaces
$505 - Onlay - Resin-Based Composite - Four Or More Surfaces
$509 - Inlay - Metallic - Two Surfaces
$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 Two Surfaces
$52 - Removal Of Fixed Space Maintainer
$520 - Connecting Bar ? Implant Supported Or Abutment Supported
$525 - Pedicle Soft Tissue Graft Procedure
$528 - Inlay - Porcelain/Ceramic - One Surface
$53 - Palliative (Emergency) Treatment Of Dental Pain - Minor Procedure
$535 - Onlay -Porcelain/Ceramic Two Surfaces
$536 - Labial Veneer (Porcelain Laminate) - Laboratory
$536 - Free Soft Tissue Graft Procedure (Including Donor Site Surgery) First Tooth Or Edentulous Tooth Position In Graft
$536 - Free Soft Tissue Graft Procedure (Including Donor Site Surgery) Each Additional Contiguous Tooth Or Edentulous Tooth Position In Same Graft Site
$54 - Recement Inlay Onlay Or Partial Coverage Restoration
$54 - Recement Cast Or Prefabricated Post And Core
$54 - Recement Crown
$54 - Non-Intravenous Conscious Sedation
$546 - Inlay - Porcelain/Ceramic Three Or More Surfaces
$546 - Inlay - Cast Predominantly Base Metal Three Or More Surfaces
$548 - Surgical Reduction Of Osseous Tuberosity
$55 - Extraction Coronal Remnants - Deciduous Tooth
$550 - Onlay - Cast Predominantly Base Metal Two Surfaces
$555 - Pontic - Porcelain Fused To Predominantly Base Metal
$556 - Pontic - Indirect Resin Based Composite
$557 - Inlay - Porcelain/Ceramic - Two Surfaces
$557 - Retreatment Of Previous Root Canal Therapy - Anterior
$557 - Inlay - Cast Noble Metal Three Or More Surfaces
$557 - Removal Of Lateral Exostosis (Maxilla Or Mandible)
$56 - Enamel Microabrasion
$56 - External Bleaching - Per Tooth
$562 - Onlay - Cast Noble Metal Two Surfaces
$564 - Crown - Indirect Resin Based Composite
$565 - Onlay - Cast High Noble Metal Two Surfaces
$57 - Protective Restoration
$57 - Interim Therapeutic Restoration ? Primary Dentition
$574 - Onlay - Cast Noble Metal Three Or More Surfaces
$575 - Onlay - Metallic-Two Surfaces
$577 - Onlay - Porcelain/Ceramic - Two Surfaces
$577 - Onlay - Porcelain/Ceramic Three Or More Surfaces
$577 - Biopsy Of Oral Tissue - Hard (Bone Tooth)
$578 - Inlay - Cast High Noble Metal Three Or More Surfaces
$580 - Pontic - Cast Predominantly Base Metal
$587 - Inlay - Metallic - Three Or More Surfaces
$587 - Pontic - Porcelain Fused To Noble Metal
$587 - Inlay - Titanium
$587 - Onlay - Titanium
$588 - Apicoectomy/Periradicular Surgery - Molar (First Root)
$588 - Onlay - Cast Predominantly Base Metal Three Or More Surfaces
$589 - Crown - 3/4 Cast Predominantly Base Metal
$59 - Fixed Partial Denture Sectioning
$594 - Inlay - Porcelain/Ceramic - Three Or More Surfaces
$598 - Subepithelial Connective Tissue Graft Procedures Per Tooth
$598 - Autogenous Connective Tissue Graft Procedure (Including Donor And Recipient Surgical Sites) ? Each Additional Contiguous Tooth Implant Or Edentulous Tooth Position In Same Graft Site
$599 - Crown - Porcelain Fused To Predominantly Base Metal
$599 - Crown - Full Cast Predominantly Base Metal
$599 - Crown - Full Cast Noble Metal
$60 - Diagnostic Casts
$602 - Onlay - Metallic-Three Surfaces
$602 - Pontic - Cast Noble Metal
$608 - Crown - 3/4 Cast Noble Metal
$611 - Pontic - Porcelain Fused To High Noble Metal
$615 - Removal Of Torus Mandibularis
$618 - Pontic - Cast High Noble Metal
$620 - Pontic - Titanium
$620 - Onlay - Cast High Noble Metal Three Or More Surfaces
$620 - Crown - Porcelain Fused To Noble Metal
$620 - Crown - Full Cast High Noble Metal
$622 - Onlay - Porcelain/Ceramic - Three Surfaces
$625 - Crown - 3/4 Cast High Noble Metal
$626 - Onlay - Metallic-Four Or More Surfaces
$629 - Pontic - Porcelain/Ceramic
$63 - Panoramic Film
$63 - Localized Delivery Of Antimicrobial Agents Via A Controlled Release Vehicle Into Diseased Crevicular Tissue Per Tooth By Report
$639 - Maxillary Partial Denture - Resin Base (Including Any Conventional Clasps Rests And Teeth)
$639 - Immediate Maxillary Partial Denture ? Resin Base (Including Any Conventional Clasps Rests And Teeth)
$639 - Crown - Titanium
$639 - Pediatric Partial Denture Fixed
$651 - Crown - Porcelain/Ceramic Substrate
$651 - Retreatment Of Previous Root Canal Therapy - Bicuspid
$651 - Crown - Porcelain/Ceramic
$651 - Crown - 3/4 Porcelain/Ceramic
$652 - Removal Of Torus Palatinus
$656 - Endodontic Therapy Molar (Excluding Final Restoration)
$66 - Recement Implant/Abutment Supported Crown
$660 - Onlay - Porcelain/Ceramic - Four Or More Surfaces
$670 - Osseous Surgery (Including Flap Entry And Closure) - Four Or More Contiguous Teeth Or Tooth Bounded Spaces Per Quadrant
$672 - Crown - Porcelain Fused To High Noble Metal
$68 - Amalgam - One Surface Primary Or Permanent
$69 - Replace Missing Or Broken Teeth - Complete Denture (Each Tooth)
$69 - Brush Biopsy - Transepithelial Sample Collection
$693 - Overdenture ? Partial Maxillary
$693 - Overdenture ? Partial Mandibular
$70 - Occlusal Adjustment - Limited
$700 - Combined Connective Tissue And Double Pedicle Graft Per Tooth
$715 - Mandibular Partial Denture - Resin Base (Including Any Conventional Clasps Rests And Teeth)
$715 - Immediate Mandibular Partial Denture ? Resin Base (Including Any Conventional Clasps Rests And Teeth)
$72 - Intraoral - Complete Series (Including Bitewings)
$72 - Replacement Of Semi-Precision Or Precision Attachment (Male Or Female Component) Of Implant/Abutment Supported Prosthesis Per Attachment
$72 - Recement Implant/Abutment Supported Fixed Partial Denture
$72 - Office Visit - After Regularly Scheduled Hours
$73 - Tissue Conditioning Maxillary
$73 - Tissue Conditioning Mandibular
$735 - Complete Denture - Maxillary
$735 - Complete Denture - Mandibular
$735 - Overdenture ? Complete Maxillary
$735 - Overdenture ? Complete Mandibular
$74 - Odontoplasty 1 - 2 Teeth; Includes Removal Of Enamel Projections
$75 - Periodontal Scaling And Root Planing - One To Three Teeth Per Quadrant
$75 - 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
$756 - Incision And Drainage Of Abscess - Extraoral Soft Tissue
$76 - Scaling In Presence Of Generalized Moderate Or Severe Gingival Inflammation ? Full Mouth After Oral Evaluation
$76 - Periodontal Maintenance
$76 - Replace Broken Teeth - Per Tooth
$76 - Recement Fixed Partial Denture
$762 - Abutment Supported Crown - (Titanium)
$77 - Additional Procedures To Construct New Crown Under Existing Partial Denture Framework
$77 - Exfoliative Cytological Sample Collection
$78 - Cephalometric Film
$79 - Full Mouth Debridement To Enable Comprehensive Evaluation And Diagnosis
$79 - Extraction Erupted Tooth Or Exposed Root (Elevation And/Or Forceps Removal)
$79 - Repair Of Orthodontic Appliance
$793 - Abutment Supported Cast Metal Crown (Predominantly Base Metal)
$803 - Abutment Supported Retainer Crown For Fpd - (Titanium)
$806 - Retreatment Of Previous Root Canal Therapy - Molar
$814 - Maxillary Partial Denture - Flexible Base (Including Any Clasps Rests And Teeth)
$814 - Mandibular Partial Denture - Flexible Base (Including Any Clasps Rests And Teeth)
$819 - Immediate Denture - Maxillary
$819 - Immediate Denture - Mandibular
$82 - Resin-Based Composite - One Surface Anterior
$82 - Reattachment Of Tooth Fragment Incisal Edge Or Cusp
$82 - intravenous moderate (conscious) sedation/analgesia- first 15 minutes
$82 - Intravenous Moderate (Conscious) Sedation/Analgesia ? Each 15 Minute Increment
$83 - repair broken complete denture base mandibular
$83 - repair broken complete denture base maxillary
$830 - Maxillary Partial Denture - Cast Metal Framework With Resin Denture Bases (Including Any Conventional Clasps Rests And Teeth)
$830 - Mandibular Partial Denture - Cast Metal Framework With Resin Denture Bases (Including Any Conventional Clasps Rests And Teeth)
$830 - Immediate Maxillary Partial Denture ? Cast Metal Framework With Resin Denture Bases (Including Any Conventional Clasps Rests And Teeth)
$830 - Immediate Mandibular Partial Denture ? Cast Metal Framework With Resin Denture Bases (Including Any Conventional Clasps Rests And Teeth)
$830 - Incision And Drainage Of Abscess - Extraoral Soft Tissue - Complicated (Includes Drainage Of Multiple Fascial Spaces)
$845 - Abutment Supported Cast Metal Crown (Noble Metal)
$86 - Amalgam - Two Surfaces Primary Or Permanent
$876 - Abutment Supported Retainer For Cast Metal Fpd (Predominantly Base Metal)
$88 - Each Additional Prefabricated Post - Same Tooth
$90 - repair resin partial denture base mandibular
$90 - repair resin partial denture base maxillary
$906 - Abutment Supported Porcelain Fused To Metal Crown (Predominantly Base Metal)
$906 - Implant Supported Metal Crown (Titanium Titanium Alloy High Noble Metal)
$91 - Incision And Drainage Of Abscess - Intraoral Soft Tissue
$92 - Resin-Based Composite - One Surface Posterior
$926 - Implant Supported Retainer For Cast Metal Fpd (Titanium Titanium Alloy Or High Noble Metal)
$927 - Abutment Supported Porcelain Fused To Metal Crown (Noble Metal)
$927 - Abutment Supported Cast Metal Crown (High Noble Metal)
$929 - Abutment Supported Retainer For Porcelain Fused To Metal Fpd (Predominantly Base Metal)
$93 - Interim Caries Arresting Medicament Application
$93 - Implant Maintenance Procedures Including Removal Of Prosthesis Cleansing Of Prosthesis And Abutments And Reinsertion Of Prosthesis
$931 - Abutment Supported Retainer For Cast Metal Fpd (Noble Metal)
$937 - Implant Supported Porcelain Fused To Metal Crown (Titanium Titanium Alloy High Noble Metal)
$948 - Abutment Supported Retainer For Porcelain Fused To Metal Fpd (Noble Metal)
$954 - Implant Supported Retainer For Porcelain Fused To Metal Fpd (Titanium Titanium Alloy Or High Noble Metal)
$958 - Implant Supported Porcelain/Ceramic Crown
$959 - Abutment Supported Retainer For Cast Metal Fpd (High Noble Metal)
$96 - Therapeutic Pulpotomy (Excluding Final Restoration) - Removal Of Pulp Coronal To The Dentinocemental Junction And Application Of Medicament
$968 - Abutment Supported Porcelain Fused To Metal Crown (High Noble Metal)
$979 - Abutment Supported Porcelain/Ceramic Crown
$980 - Implant Supported Retainer For Ceramic Fpd
$983 - Abutment Supported Retainer For Porcelain Fused To Metal Fpd (High Noble Metal)
$987 - Abutment Supported Retainer For Porcelain/Ceramic Fpd
1220 STUBBS AVE MONROE LA 71201