diff --git a/src/main/java/org/mitre/synthea/engine/Distribution.java b/src/main/java/org/mitre/synthea/engine/Distribution.java index 35fd34cf11..b558741ade 100644 --- a/src/main/java/org/mitre/synthea/engine/Distribution.java +++ b/src/main/java/org/mitre/synthea/engine/Distribution.java @@ -11,7 +11,7 @@ */ public class Distribution implements Serializable { public enum Kind { - EXACT, GAUSSIAN, UNIFORM, EXPONENTIAL + EXACT, GAUSSIAN, UNIFORM, EXPONENTIAL, TRIANGULAR } public Kind kind; @@ -50,8 +50,23 @@ public double generate(Person person) { break; case EXPONENTIAL: double average = this.parameters.get("mean"); - double lambda = (1.0d / average); - value = 1.0d + Math.log(1.0d - person.rand()) / (-1.0d * lambda); + double lambda = (-1.0d / average); + value = 1.0d + Math.log(1.0d - person.rand()) / lambda; + break; + case TRIANGULAR: + /* Pick a single value based on a triangular distribution. See: + * https://en.wikipedia.org/wiki/Triangular_distribution + */ + double min = this.parameters.get("min"); + double mode = this.parameters.get("mode"); + double max = this.parameters.get("max"); + double f = (mode - min) / (max - min); + double rand = person.rand(); + if (rand < f) { + value = min + Math.sqrt(rand * (max - min) * (mode - min)); + } else { + value = max - Math.sqrt((1 - rand) * (max - min) * (max - mode)); + } break; default: value = -1; @@ -81,6 +96,10 @@ public boolean validate() { && this.parameters.containsKey("standardDeviation"); case EXPONENTIAL: return this.parameters.containsKey("mean"); + case TRIANGULAR: + return this.parameters.containsKey("min") + && this.parameters.containsKey("mode") + && this.parameters.containsKey("max"); default: return false; } diff --git a/src/main/java/org/mitre/synthea/export/CSVExporter.java b/src/main/java/org/mitre/synthea/export/CSVExporter.java index 9dc336001e..8573bc270f 100644 --- a/src/main/java/org/mitre/synthea/export/CSVExporter.java +++ b/src/main/java/org/mitre/synthea/export/CSVExporter.java @@ -308,14 +308,14 @@ private void writeCSVHeaders() throws IOException { "START,STOP,PATIENT,PAYER,ENCOUNTER,CODE,DESCRIPTION,BASE_COST,PAYER_COVERAGE,DISPENSES," + "TOTALCOST,REASONCODE,REASONDESCRIPTION"); medications.write(NEWLINE); - conditions.write("START,STOP,PATIENT,ENCOUNTER,CODE,DESCRIPTION"); + conditions.write("START,STOP,PATIENT,ENCOUNTER,SYSTEM,CODE,DESCRIPTION"); conditions.write(NEWLINE); careplans.write( "Id,START,STOP,PATIENT,ENCOUNTER,CODE,DESCRIPTION,REASONCODE,REASONDESCRIPTION"); careplans.write(NEWLINE); observations.write("DATE,PATIENT,ENCOUNTER,CATEGORY,CODE,DESCRIPTION,VALUE,UNITS,TYPE"); observations.write(NEWLINE); - procedures.write("START,STOP,PATIENT,ENCOUNTER,CODE,DESCRIPTION,BASE_COST," + procedures.write("START,STOP,PATIENT,ENCOUNTER,SYSTEM,CODE,DESCRIPTION,BASE_COST," + "REASONCODE,REASONDESCRIPTION"); procedures.write(NEWLINE); immunizations.write("DATE,PATIENT,ENCOUNTER,CODE,DESCRIPTION,BASE_COST"); @@ -752,7 +752,7 @@ private String encounter(String personID, * @throws IOException if any IO error occurs */ private void condition(String personID, String encounterID, Entry condition) throws IOException { - // START,STOP,PATIENT,ENCOUNTER,CODE,DESCRIPTION + // START,STOP,PATIENT,ENCOUNTER,SYSTEM,CODE,DESCRIPTION StringBuilder s = new StringBuilder(); s.append(dateFromTimestamp(condition.start)).append(','); @@ -765,6 +765,7 @@ private void condition(String personID, String encounterID, Entry condition) thr Code coding = condition.codes.get(0); + s.append(coding.system).append(','); s.append(coding.code).append(','); s.append(clean(coding.display)); @@ -903,7 +904,7 @@ private void observation(String personID, */ private void procedure(String personID, String encounterID, Procedure procedure) throws IOException { - // START,STOP,PATIENT,ENCOUNTER,CODE,DESCRIPTION,COST,REASONCODE,REASONDESCRIPTION + // START,STOP,PATIENT,ENCOUNTER,SYSTEM,CODE,DESCRIPTION,COST,REASONCODE,REASONDESCRIPTION StringBuilder s = new StringBuilder(); s.append(iso8601Timestamp(procedure.start)).append(','); @@ -915,6 +916,7 @@ private void procedure(String personID, String encounterID, s.append(encounterID).append(','); // CODE Code coding = procedure.codes.get(0); + s.append(coding.system).append(','); s.append(coding.code).append(','); // DESCRIPTION s.append(clean(coding.display)).append(','); diff --git a/src/main/java/org/mitre/synthea/export/ExportHelper.java b/src/main/java/org/mitre/synthea/export/ExportHelper.java index 521406b323..2d910df0da 100644 --- a/src/main/java/org/mitre/synthea/export/ExportHelper.java +++ b/src/main/java/org/mitre/synthea/export/ExportHelper.java @@ -214,6 +214,9 @@ public static long nextFriday(long time) { private static final String CVX_URI = "http://hl7.org/fhir/sid/cvx"; private static final String DICOM_DCM_URI = "http://dicom.nema.org/medical/dicom/current/output/chtml/part16/sect_CID_29.html"; private static final String CDT_URI = "http://www.ada.org/cdt"; + private static final String ICD9_URI = "http://hl7.org/fhir/sid/icd-9-cm"; + private static final String ICD10_URI = "http://hl7.org/fhir/sid/icd-10"; + private static final String ICD10_CM_URI = "http://hl7.org/fhir/sid/icd-10-cm"; /** * Translate the system name (e.g. SNOMED-CT) into the official @@ -234,6 +237,12 @@ public static String getSystemURI(String system) { system = DICOM_DCM_URI; } else if (system.equals("CDT")) { system = CDT_URI; + } else if (system.equals("ICD9")) { + system = ICD9_URI; + } else if (system.equals("ICD10")) { + system = ICD10_URI; + } else if (system.equals("ICD10-CM")) { + system = ICD10_CM_URI; } return system; } @@ -258,6 +267,12 @@ public static String getSystemFromURI(String uri) { return "DICOM-DCM"; case CDT_URI: return "CDT"; + case ICD9_URI: + return "ICD9"; + case ICD10_URI: + return "ICD10"; + case ICD10_CM_URI: + return "ICD10-CM"; default: return "Unknown"; } diff --git a/src/main/java/org/mitre/synthea/export/rif/CodeMapper.java b/src/main/java/org/mitre/synthea/export/rif/CodeMapper.java index 5f683eead3..b5e3ed4e3b 100644 --- a/src/main/java/org/mitre/synthea/export/rif/CodeMapper.java +++ b/src/main/java/org/mitre/synthea/export/rif/CodeMapper.java @@ -263,7 +263,7 @@ public List> getMissingCodes() { row.put("count", count.toString()); missingCodeList.add(row); }); - // sort in decending order by count + // sort in descending order by count Collections.sort(missingCodeList, (o1, o2) -> { return (int)(Long.parseLong(o2.get("count")) - Long.parseLong(o1.get("count"))); }); diff --git a/src/main/java/org/mitre/synthea/export/rif/RIFExporter.java b/src/main/java/org/mitre/synthea/export/rif/RIFExporter.java index 319aa452fa..5526a9e22e 100644 --- a/src/main/java/org/mitre/synthea/export/rif/RIFExporter.java +++ b/src/main/java/org/mitre/synthea/export/rif/RIFExporter.java @@ -188,7 +188,11 @@ protected List getDiagnosesCodes(Person person, long time) { if (encounter.start <= time) { for (HealthRecord.Entry dx : encounter.conditions) { if (dx.start <= time && (dx.stop == 0L || dx.stop > time)) { - if (exporter.conditionCodeMapper.canMap(dx.codes.get(0))) { + if (dx.codes.get(0).system.startsWith("ICD10")) { + // Temporarily duplicate the code... we'll remove it later. + dx.codes.add(dx.codes.get(0)); + diagnoses.add(dx); + } else if (exporter.conditionCodeMapper.canMap(dx.codes.get(0))) { String mapped = exporter.conditionCodeMapper.map(dx.codes.get(0), person, true); // Temporarily add the mapped code... we'll remove it later. HealthRecord.Code mappedCode = new HealthRecord.Code("ICD10", mapped, @@ -234,7 +238,9 @@ protected long getEarliestDiagnosis(Person person, String code) { List diagnoses = new ArrayList(); for (HealthRecord.Encounter encounter : person.record.encounters) { for (HealthRecord.Entry dx : encounter.conditions) { - if (exporter.conditionCodeMapper.canMap(dx.codes.get(0).code)) { + if (dx.codes.get(0).system.startsWith("ICD10")) { + diagnoses.add(dx); + } else if (exporter.conditionCodeMapper.canMap(dx.codes.get(0).code)) { String mapped = exporter.conditionCodeMapper.map(dx.codes.get(0).code, person, true); if (mapped.equals(code)) { diagnoses.add(dx); diff --git a/src/main/java/org/mitre/synthea/world/concepts/Costs.java b/src/main/java/org/mitre/synthea/world/concepts/Costs.java index 4ec58eadd8..534b365f8d 100644 --- a/src/main/java/org/mitre/synthea/world/concepts/Costs.java +++ b/src/main/java/org/mitre/synthea/world/concepts/Costs.java @@ -6,8 +6,8 @@ import java.util.List; import java.util.Map; +import org.mitre.synthea.engine.Distribution; import org.mitre.synthea.helpers.Config; -import org.mitre.synthea.helpers.RandomNumberGenerator; import org.mitre.synthea.helpers.SimpleCSV; import org.mitre.synthea.helpers.Utilities; import org.mitre.synthea.world.agents.Person; @@ -16,6 +16,8 @@ import org.mitre.synthea.world.geography.Location; public class Costs { + private static final Distribution.Kind COST_METHOD = parseCostMethod(); + // all of these are CSVs with these columns: // code, min cost in $, mode cost in $, max cost in $, comments private static final Map PROCEDURE_COSTS = @@ -144,7 +146,7 @@ public static double determineCostOfEntry(Entry entry, Person person) { return 0.0; } - String code = entry.codes.get(0).code;; + String code = entry.codes.get(0).code; // Retrieve the base cost based on the code. double baseCost; if (costs != null && costs.containsKey(code)) { @@ -256,6 +258,17 @@ private static Map parseEncounterAdjustmentFactors(String resour } } + /** + * Load the cost methodology. + * @return a Distribution.Kind enum value. Defaults to Triangular. + */ + private static Distribution.Kind parseCostMethod() { + String configValue = + Config.get("generate.costs.method", Distribution.Kind.TRIANGULAR.toString()); + Distribution.Kind distribution = Distribution.Kind.valueOf(configValue.toUpperCase()); + return distribution; + } + /** * Whether or not this HealthRecord.Entry has an associated cost on a claim. * Billing cost is not necessarily reimbursed cost or paid cost. @@ -298,39 +311,64 @@ protected static class CostData { private double min; private double mode; private double max; + private Distribution distribution; - private CostData(double min, double mode, double max) { + CostData(double min, double mode, double max) { this.min = min; this.mode = mode; this.max = max; + this.distribution = new Distribution(); + this.distribution.kind = COST_METHOD; + this.distribution.round = false; + this.distribution.parameters = new HashMap(); + switch (COST_METHOD) { + case EXACT: + this.distribution.parameters.put("value", this.mode); + break; + case UNIFORM: + this.distribution.parameters.put("low", this.min); + this.distribution.parameters.put("high", this.max); + break; + case GAUSSIAN: + this.distribution.parameters.put("mean", this.mode); + this.distribution.parameters.put("min", this.min); + this.distribution.parameters.put("max", this.max); + double left = (this.mode - this.min) / 4.0d; + double right = (this.max - this.mode) / 4.0d; + double sd = Math.min(left, right); + this.distribution.parameters.put("standardDeviation", sd); + break; + case EXPONENTIAL: + this.distribution.parameters.put("mean", this.mode); + break; + case TRIANGULAR: + this.distribution.parameters.put("min", this.min); + this.distribution.parameters.put("mode", this.mode); + this.distribution.parameters.put("max", this.max); + break; + default: + break; + } } /** - * Select an individual cost based on this cost data. Uses a triangular - * distribution to pick a randomized value. - * @param rand Source of randomness + * Select an individual cost based on this cost data. + * @param person Source of randomness * @return Single cost within the range this set of cost data represents */ - private double chooseCost(RandomNumberGenerator rand) { - return triangularDistribution(min, max, mode, rand.rand()); - } + protected double chooseCost(Person person) { + double value = this.distribution.generate(person); - /** - * Pick a single value based on a triangular distribution. See: - * https://en.wikipedia.org/wiki/Triangular_distribution - * @param min Lower limit of the distribution - * @param max Upper limit of the distribution - * @param mode Most common value - * @param rand A random value between 0-1 - * @return a single value from the distribution - */ - public static double triangularDistribution(double min, double max, double mode, double rand) { - double f = (mode - min) / (max - min); - if (rand < f) { - return min + Math.sqrt(rand * (max - min) * (mode - min)); - } else { - return max - Math.sqrt((1 - rand) * (max - min) * (max - mode)); + if (COST_METHOD.equals(Distribution.Kind.EXPONENTIAL)) { + value = value - 1.0; + } + + if (value < this.min) { + value = this.min; + } else if (value > this.max) { + value = this.max; } + return value; } } } \ No newline at end of file diff --git a/src/main/java/org/mitre/synthea/world/concepts/HealthRecord.java b/src/main/java/org/mitre/synthea/world/concepts/HealthRecord.java index e567fd34d6..be74e8074d 100644 --- a/src/main/java/org/mitre/synthea/world/concepts/HealthRecord.java +++ b/src/main/java/org/mitre/synthea/world/concepts/HealthRecord.java @@ -98,7 +98,7 @@ public boolean equals(Object obj) { * * @param system the URI identifier of the code system * @param code the code itself - * @param display human-readable description of the coe + * @param display human-readable description of the code */ public Code(String system, String code, String display) { this.system = system; diff --git a/src/main/resources/costs/procedures.csv b/src/main/resources/costs/procedures.csv index 409eb811fe..4d888f708a 100644 --- a/src/main/resources/costs/procedures.csv +++ b/src/main/resources/costs/procedures.csv @@ -234,268 +234,2847 @@ CODE,MIN,MODE,MAX,COMMENTS 271280005,138,239,239,Removal of endotracheal tube (procedure) - https://www.medicare.gov/procedure-price-lookup/cost/31502 36576007,389,447.5,506,Infusion (procedure) - https://www.medicare.gov/procedure-price-lookup/cost/77750 706004007,7817,9034,10251,Implantable cardiac pacemaker (physical object) - https://www.medicare.gov/procedure-price-lookup/cost/33208 -D0120,39,54.79,78,periodic oral evaluation - established patient -D0140,50,75.91,110,limited oral evaluation - problem focused -D0145,40,65.4,103,oral evaluation for a patient under three years of age and counseling with primary caregiver -D0150,60,87.19,126,comprehensive oral evaluation - new or established patient -D0160,58,126.68,208,detailed and extensive oral evaluation - problem focused by report -D0170,35,62.9,100,re-evaluation - limited problem focused (established patient; not post-operative visit) -D0171,0,27.21,88,re-evaluation post-operative office visit -D0180,72,100.67,150,comprehensive periodontal evaluation - new or established patient -D0190,25,61.14,114,screening of a patient -D0191,25,60.62,150,assessment of a patient -D0210,110,143.3,195,intraoral - complete series of radiographic images -D0220,21,30.99,45,intraoral - periapical first radiographic image -D0230,16,25.3,38,intraoral - periapical each additional radiographic image -D0251,0,35.9,89,extra-oral posterior dental radiographic image -D0272,37,48.94,69,bitewings - two radiographic images -D0273,45,59.09,82,bitewings - three radiographic images -D0274,53,69.76,95,bitewings - four radiographic images -D0277,74,101.21,140,vertical bitewings - 7 to 8 radiographic images -D0330,95,123.36,166,panoramic radiographic image -D0350,0,56.65,120,2D oral/facial photographic image obtained intra-orally or extra-orally -D0364,125,256.6,432,cone beam CT capture and interpretation with limited field of view less than one whole jaw -D0365,155,298.99,500,cone beam CT capture and interpretation with field of view of one full dental arch mandible -D0366,150,297.93,500,cone beam CT capture and interpretation with field of view of one full dental arch maxilla with or without cranium -D0367,170,327.17,515,cone beam CT capture and interpretation with field of view of both jaws; with or without cranium -D0417,32,148.61,260,collection and preparation of saliva sample for laboratory diagnostic testing -D0418,72,155.23,290,analysis of saliva sample -D0431,29,63.53,95,adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions not to include cytology or biopsy procedures -D0470,69,121.41,250,diagnostic casts -D0601,10,39.35,90,caries risk assessment and documentation with a finding of low risk -D0602,8,37.48,87,caries risk assessment and documentation with a finding of moderate risk -D0603,8,37.41,88,caries risk assessment and documentation with a finding of high risk -D1110,74,97.5,135,prophylaxis - adult -D1120,55,73.04,102,prophylaxis - child -D1206,28,41.96,62,topical application of fluoride varnish -D1208,27,39.89,57,topical application of fluoride excluding varnish -D1320,0,38.2,97,tobacco counseling for the control and prevention of oral disease -D1330,0,32.05,71,oral hygiene instructions -D1351,42,57.1,80,sealant - per tooth -D1352,51,99.32,175,preventive resin restoration in a moderate to high caries risk patient permanent tooth -D1354,22,54.53,125,interim caries arresting medicament application per tooth -D1510,250,328.92,450,space maintainer - fixed unilateral per quadrant -D1515,335,441.18,599,space maintainer - fixed bilateral -D2140,104,145.78,200,amalgam - one surface primary or permanent -D2150,130,181.77,250,amalgam - two surfaces primary or permanent -D2160,155,218.02,305,amalgam - three surfaces primary or permanent -D2161,180,257.28,362,amalgam - four or more surfaces primary or permanent -D2330,130,174.13,247,resin-based composite - one surface anterior -D2331,159,212.11,293,resin-based composite - two surfaces anterior -D2332,189,256.04,350,resin-based composite - three surfaces anterior -D2335,220,310.07,430,resin-based composite - four or more surfaces or involving incisal angle (anterior) -D2390,260,455.26,749,resin-based composite crown anterior -D2391,144,190.99,260,resin-based composite - one surface posterior -D2392,180,242.48,332,resin-based composite - two surfaces posterior -D2393,218,294.82,401,resin-based composite - three surfaces posterior -D2394,250,344.06,472,resin-based composite - four or more surfaces posterior -D2520,615,917.92,1422,inlay - metallic - two surfaces -D2543,770,1070.33,1550,onlay - metallic - three surfaces -D2620,700,991.59,1418,inlay - porcelain/ceramic - two surfaces -D2642,769,1059.45,1467,onlay - porcelain/ceramic - two surfaces -D2643,869,1117.26,1500,onlay - porcelain/ceramic - three surfaces -D2644,900,1164.29,1576,onlay - porcelain/ceramic - four or more surfaces -D2651,600,891.25,1290,inlay - resin-based composite - two surfaces -D2662,585,915.34,1293,onlay - resin-based composite - two surfaces -D2663,650,968.6,1300,onlay - resin-based composite - three surfaces -D2664,700,1027.09,1423,onlay - resin-based composite - four or more surfaces -D2710,400,826.53,1367,crown - resin-based composite (indirect) -D2740,970,1213.08,1600,crown - porcelain/ceramic -D2750,950,1201.52,1600,crown - porcelain fused to high noble metal -D2751,857,1095.76,1468,crown - porcelain fused to predominantly base metal -D2752,900,1140.42,1500,crown - porcelain fused to noble metal -D2780,900,1168.94,1590,crown - 3/4 cast high noble metal -D2783,940,1198.26,1638,crown - 3/4 porcelain/ceramic -D2790,973,1240.88,1673,crown - full cast high noble metal -D2794,900,1195.54,1698,crown - titanium and titanium alloys -D2799,120,356.87,600,provisional crown further treatment or completion of diagnosis necessary prior to final impression -D2920,80,114.64,171,re-cement or re-bond crown -D2929,211,345.69,518,prefabricated porcelain/ceramic crown primary tooth -D2930,200,283.56,400,prefabricated stainless steel crown - primary tooth -D2931,250,336.67,450,prefabricated stainless steel crown - permanent tooth -D2940,81,126.23,200,protective restoration -D2949,60,176.92,325,restorative foundation for an indirect restoration -D2950,202,282.49,397,core buildup including any pins when required -D2952,299,411.52,557,post and core in addition to crown indirectly fabricated -D2954,255,348.17,483,prefabricated post and core in addition to crown -D2961,659,1013.1,1450,labial veneer (resin laminate) - laboratory -D2962,953,1230.66,1618,labial veneer (porcelain laminate) - laboratory -D2980,165,268.67,402,crown repair necessitated by restorative material failure -D2981,193,269.14,361,inlay repair necessitated by restorative material failure -D2982,193,289.48,541,onlay repair necessitated by restorative material failure -D2983,128,261.16,425,veneer repair necessitated by restorative material failure -D2990,50,148.79,350,resin infiltration of incipient smooth surface lesions -D3110,50,84.4,134,pulp cap - direct (excluding final restoration) -D3120,49,81.75,130,pulp cap - indirect (excluding final restoration) -D3220,125,201.5,315,therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction and application of medicament -D3221,125,218.16,361,pulpal debridement primary and permanent teeth -D3222,145,259.23,400,partial pulpotomy for apexogenesis - permanent tooth with incomplete root development -D3230,172,256.12,374,pulpal therapy (resorbable filling) - anterior primary tooth (excluding final restoration) -D3240,183,283.96,419,pulpal therapy (resorbable filling) - posterior primary tooth (excluding final restoration) -D3310,620,799.76,1100,endodontic therapy anterior tooth (excluding final restoration) -D3320,705,917.71,1250,endodontic therapy premolar tooth (excluding final restoration) -D3330,870,1109.31,1472,endodontic therapy molar tooth (excluding final restoration) -D3331,210,487.32,750,treatment of root canal obstruction; non- surgical access -D3332,103,385.88,625,incomplete endodontic therapy; inoperable unrestorable or fractured tooth -D3346,670,911.61,1305,retreatment of previous root canal therapy - anterior -D3347,760,1044.12,1454,retreatment of previous root canal therapy - premolar -D3348,900,1246.06,1700,retreatment of previous root canal therapy - molar -D3351,250,366.28,524,apexification/recalcification initial visit (apical closure / calcific repair of perforations root resorption etc.) -D3352,149,239.73,353,apexification/recalcification interim medication replacement -D3353,378,556.64,800,apexification/recalcification - final visit (includes completed root canal therapy - apical closure/calcific repair of perforations root resorption etc.) -D3355,277,414.35,619,pulpal regeneration - initial visit -D3356,147,261.7,511,pulpal regeneration - interim medication replacement -D3357,195,488.61,721,pulpal regeneration - completion of treatment -D3410,518,767.4,1140,apicoectomy - anterior -D3421,600,849.16,1270,apicoectomy - premolar (first root) -D3425,700,961.87,1452,apicoectomy - molar (first root) -D3426,250,380.16,562,apicoectomy (each additional root) -D4210,385,612.88,907,gingivectomy or gingivoplasty - four or more contiguous teeth or tooth bounded spaces per quadrant -D4211,180,299.46,464,gingivectomy or gingivoplasty - one to three contiguous teeth or tooth bounded spaces per quadrant -D4212,100,235.76,456,gingivectomy or gingivoplasty to allow access for restorative procedure per tooth -D4240,446,751.41,1150,gingival flap procedure including root planing - four or more contiguous teeth or tooth bounded spaces per quadrant -D4241,300,573.17,905,gingival flap procedure including root planing - one to three contiguous teeth or tooth bounded spaces per quadrant -D4249,450,761.96,1153,clinical crown lengthening hard tissue -D4260,733,1144.38,1654,osseous surgery (including elevation of a full thickness flap and closure) four or more contiguous teeth or tooth bounded spaces per quadrant -D4261,561,906.77,1400,osseous surgery (including elevation of a full thickness flap and closure) one to three contiguous teeth or tooth bounded spaces per quadrant -D4263,325,597.86,927,bone replacement graft retained natural tooth first site in quadrant -D4264,260,466.03,737,bone replacement graft retained natural tooth each additional site in quadrant -D4266,263,608.23,1027,guided tissue regeneration - resorbable barrier per site -D4267,318,698.3,1150,guided tissue regeneration - nonresorbable barrier per site (includes membrane removal) -D4273,779,1128.05,1610,autogenous connective tissue graft procedure (including donor and recipient surgical sites) first tooth implant or edentulous tooth position in graft -D4275,653,969.72,1400,non-autogenous connective tissue graft (including recipient site and donor material) first tooth implant or edentulous tooth position in graft -D4277,540,883.16,1490,free soft tissue graft procedure (including recipient and donor surgical sites) first tooth implant or edentulous tooth position in graft -D4278,288,636.03,1214,free soft tissue graft procedure (including recipient and donor surgical sites) each additional contiguous tooth implant or edentulous tooth position in same graft site -D4283,546,871.06,1500,autogenous connective tissue graft procedure (including donor and recipient surgical sites) each additional contiguous tooth implant or edentulous tooth position in same graft site -D4285,446,801.1,1500,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 -D4321,239,424.69,646,provisional splinting - extracoronal -D4341,201,266.51,355,periodontal scaling and root planing - four or more teeth per quadrant -D4342,135,189.68,267,periodontal scaling and root planing - one to three teeth per quadrant -D4355,135,187.06,274,full mouth debridement to enable a comprehensive oral evaluation and diagnosis on a subsequent visit -D4381,40,92.84,198,localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue per tooth -D4910,115,149.01,200,periodontal maintenance -D5110,1250,1739.91,2561,complete denture - maxillary -D5120,1250,1737.49,2573,complete denture - mandibular -D5130,1340,1852.49,2727,immediate denture - maxillary -D5140,1350,1850.74,2738,immediate denture - mandibular -D5211,800,1338.52,2136,maxillary partial denture resin base (including retentive/clasping materials rests and teeth) -D5212,800,1350.62,2147,mandibular partial denture resin base (including retentive/clasping materials rests and teeth) -D5213,1335,1809.27,2565,maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials rests and teeth) -D5214,1340,1811.46,2575,mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials rests and teeth) -D5221,700,1352.9,2150,immediate maxillary partial denture - resin base (including retentive/clasping materials rests and teeth) -D5222,688,1354.47,2200,immediate mandibular partial denture - resin base (including retentive/clasping materials rests and teeth) -D5223,1090,1701.1,2500,immediate maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials rests and teeth) -D5224,1190,1725.42,2500,immediate mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials rests and teeth) -D5225,1004,1503.04,2142,maxillary partial denture - flexible base (including any clasps rests and teeth) -D5226,1000,1498.05,2169,mandibular partial denture - flexible base (including any clasps rests and teeth) -D5520,124,192.6,299,replace missing or broken teeth - complete denture (each tooth) -D5640,125,197.79,309,replace broken teeth - per tooth -D5650,155,234.11,350,add tooth to existing partial denture -D5660,180,268.15,401,add clasp to existing partial denture - per tooth -D5710,395,594.67,873,rebase complete maxillary denture -D5711,400,589.98,850,rebase complete mandibular denture -D5720,375,567.73,800,rebase maxillary partial denture -D5721,376,566.31,801,rebase mandibular partial denture -D5730,199,350.42,529,reline complete maxillary denture (chairside) -D5731,200,351.32,533,reline complete mandibular denture (chairside) -D5750,300,465.57,670,reline complete maxillary denture (laboratory) -D5751,300,463.29,670,reline complete mandibular denture (laboratory) -D5986,72,169.76,288,fluoride gel carrier -D5991,113,202.54,300,vesiculobullous disease medicament carrier -D5994,40,407.71,824,periodontal medicament carrier with peripheral seal laboratory processed -D6010,1545,2013.73,2626,surgical placement of implant body: endosteal implant -D6011,165,540.06,1654,second stage implant surgery -D6012,1027,1646.55,2500,surgical placement of interim implant body for transitional prosthesis: endosteal implant -D6051,200,448.96,800,interim abutment -D6055,800,2554.28,4997,connecting bar implant supported or abutment supported -D6056,450,717.97,1072,prefabricated abutment includes modification and placement -D6057,600,872.56,1283,custom fabricated abutment includes placement -D6059,1100,1456.48,2000,abutment supported porcelain fused to metal crown (high noble metal) -D6066,1085,1511.04,2127,implant supported crown - porcelain fused to high noble alloys -D6069,1050,1443.88,2000,abutment supported retainer for porcelain fused to metal FPD (high noble metal) -D6076,1050,1509.74,2199,implant supported retainer for FPD - porcelain fused to high noble alloys -D6080,70,212.47,410,implant maintenance procedures when prostheses are removed and reinserted including cleansing of prostheses and abutments -D6100,260,640.78,1124,implant removal by report -D6104,285,552.15,980,bone graft at time of implant placement -D6205,682,982.41,1280,pontic - indirect resin based composite -D6210,910,1171.26,1590,pontic - cast high noble metal -D6240,945,1188.22,1600,pontic - porcelain fused to high noble metal -D6241,857,1094.53,1455,pontic - porcelain fused to predominantly base metal -D6245,950,1184.07,1580,pontic - porcelain/ceramic -D6253,183,553.73,1050,provisional pontic - further treatment or completion of diagnosis necessary prior to final impression -D6545,350,750.53,1250,retainer - cast metal for resin bonded fixed prosthesis -D6549,268,717.92,1427,retainer for resin bonded fixed prosthesis -D6710,748,1016.46,1340,retainer crown - indirect resin based composite -D6750,954,1204.67,1625,retainer crown - porcelain fused to high noble metal -D6751,875,1103.69,1455,retainer crown - porcelain fused to predominantly base metal -D6790,950,1202.04,1673,retainer crown - full cast high noble metal -D6793,200,487.26,1007,provisional retainer crown - further treatment or completion of diagnosis necessary prior to final impression -D6930,110,170.52,265,re-cement or re-bond fixed partial denture -D7111,88,134.94,200,extraction coronal remnants primary tooth -D7140,135,189.83,299,extraction erupted tooth or exposed root (elevation and/or forceps removal) -D7210,220,291.53,400,extraction erupted tooth requiring removal of bone and/or sectioning of tooth and including elevation of mucoperiosteal flap if indicated -D7220,250,335.51,460,removal of impacted tooth - soft tissue -D7230,312,417.17,572,removal of impacted tooth - partially bony -D7240,383,505.38,702,removal of impacted tooth - completely bony -D7250,200,304.09,427,removal of residual tooth roots (cutting procedure) -D7251,160,415.76,674,coronectomy intentional partial tooth removal -D7286,225,339.92,493,incisional biopsy of oral tissue-soft -D7287,114,188.27,311,exfoliative cytological sample collection -D7288,131,199.14,306,brush biopsy - transepithelial sample collection -D7295,287,744.59,1449,harvest of bone for use in autogenous grafting procedure -D7310,196,301.75,462,alveoloplasty in conjunction with extractions - four or more teeth or tooth spaces per quadrant -D7320,255,428.09,642,alveoloplasty not in conjunction with extractions - four or more teeth or tooth spaces per quadrant -D7410,177,394.64,807,excision of benign lesion up to 1.25 cm -D7440,264,726.64,1603,excision of malignant tumor - lesion diameter up to 1.25 cm -D7450,258,586.07,1009,removal of benign odontogenic cyst or tumor - lesion diameter up to 1.25 cm -D7640,2843,3440.72,4118,mandible - closed reduction (teeth immobilized if present) -D7880,451,876.43,1545,occlusal orthotic device by report -D7910,150,292.09,500,suture of recent small wounds up to 5 cm -D7921,100,371.34,694,collection and application of autologous blood concentrate product -D7953,262,520.15,994,bone replacement graft for ridge preservation - per site -D7960,300,441.78,625,frenulectomy - also known as frenectomy or frenotomy - separate procedure not incidental to another procedure -D7970,256,471.24,800,excision of hyperplastic tissue - per arch -D8020,1000,2692.42,5000,limited orthodontic treatment of the transitional dentition -D8030,1575,3072.72,5000,limited orthodontic treatment of the adolescent dentition -D8040,1950,3355.57,5000,limited orthodontic treatment of the adult dentition -D8050,1800,2892.85,4900,interceptive orthodontic treatment of the primary dentition -D8060,1800,2971.73,4950,interceptive orthodontic treatment of the transitional dentition -D8070,4282,5327.8,6636,comprehensive orthodontic treatment of the transitional dentition -D8080,4500,5369.51,6663,comprehensive orthodontic treatment of the adolescent dentition -D8090,4560,5426.03,6600,comprehensive orthodontic treatment of the adult dentition -D8660,82,290.44,587,pre-orthodontic treatment examination to monitor growth and development -D8670,103,248.45,464,periodic orthodontic treatment visit -D8681,51,162.16,395,removable orthodontic retainer adjustment -D8690,180,368.81,730,orthodontic treatment (alternative billing to a contract fee) -D9110,70,126.85,210,palliative (emergency) treatment of dental pain - minor procedure -D9120,75,178.32,302,fixed partial denture sectioning -D9210,30,65.14,108,local anesthesia not in conjunction with operative or surgical procedures -D9215,0,35.03,85,local anesthesia in conjunction with operative or surgical procedures -D9223,57,261.55,600,deep sedation/general anesthesia each subsequent 15 minute increment -D9230,35,72.51,145,inhalation of nitrous oxide/analgesia anxiolysis -D9243,108,204.05,417,intravenous moderate (conscious) sedation/analgesia each subsequent 15 minute increment -D9248,0,211.53,481,non-intravenous conscious sedation -D9310,0,106.84,203,consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician -D9410,89,219.17,394,house/extended care facility call -D9420,150,295.57,460,hospital or ambulatory surgical center call -D9430,0,62.88,118,office visit for observation (during regularly scheduled hours) - no other services performed -D9440,93,165.05,261,office visit - after regularly scheduled hours -D9450,77,145.42,250,case presentation detailed and extensive treatment planning -D9610,0,61.92,141,therapeutic parenteral drug single administration -D9630,0,29.23,73,drugs or medicaments dispensed in the office for home use -D9910,25,55.96,100,application of desensitizing medicament -D9911,15,63,125,application of desensitizing resin for cervical and/or root surface per tooth -D9920,50,127.23,273,behavior management by report -D9930,65,124.54,210,treatment of complications (post-surgical) - unusual circumstances by report -D9932,25,68.03,175,cleaning and inspection of removable complete denture maxillary -D9933,25,67.05,175,cleaning and inspection of removable complete denture mandibular -D9934,25,64.82,175,cleaning and inspection of removable partial denture maxillary -D9935,25,64.97,175,cleaning and inspection of removable partial denture mandibular -D9940,324,522.02,788,occlusal guard by report -D9941,100,241.4,500,fabrication of athletic mouthguard -D9943,35,96.93,225,occlusal guard adjustment -D9951,59,147.63,269,occlusal adjustment - limited -D9952,200,565.5,943,occlusal adjustment - complete -D9972,131,297.12,590,external bleaching - per arch - performed in office -D9974,150,271.67,400,internal bleaching - per tooth -D9975,108,242.1,495,external bleaching for home application per arch; includes materials and fabrication of custom trays \ No newline at end of file +D0100,0.00,8.90,500.00,oral evaluation - unknown +D0101,0.00,0.19,2328.00,oral evaluation - unknown +D0102,0.00,0.23,6906.44,oral evaluation - unknown +D0103,0.00,0.38,15080.00,oral evaluation - unknown +D0104,0.00,0.42,5575.00,oral evaluation - unknown +D0105,0.00,0.53,34257.00,oral evaluation - unknown +D0106,0.00,0.52,8560.00,oral evaluation - unknown +D0107,0.00,0.49,5575.00,oral evaluation - unknown +D0108,0.00,0.11,1800.00,oral evaluation - unknown +D0109,0.00,0.40,1639.00,oral evaluation - unknown +D0110,0.00,0.95,49410.00,oral evaluation - unknown +D0111,0.00,5.69,40.00,oral evaluation - unknown +D0112,0.00,0.00,0.00,oral evaluation - unknown +D0113,0.00,0.00,0.00,oral evaluation - unknown +D0114,0.00,6.47,85.00,oral evaluation - unknown +D0115,0.00,69.23,900.00,oral evaluation - unknown +D0116,0.00,0.00,0.00,oral evaluation - unknown +D0117,0.00,0.00,0.00,oral evaluation - unknown +D0119,0.00,0.00,0.00,oral evaluation - unknown +D0120,0.00,14.56,14724.75,periodic oral evaluation - established patient +D0121,0.00,39.58,950.00,oral evaluation - unknown +D0122,0.00,0.00,0.00,oral evaluation - unknown +D0123,0.00,0.00,0.00,oral evaluation - unknown +D0124,0.00,0.00,0.00,oral evaluation - unknown +D0125,0.00,0.00,0.00,oral evaluation - unknown +D0127,35.00,35.00,35.00,oral evaluation - unknown +D0130,0.00,6.05,375.00,oral evaluation - unknown +D0133,0.00,0.00,0.00,oral evaluation - unknown +D0140,0.00,10.20,28629.00,limited oral evaluation - problem focused +D0141,0.00,0.00,0.00,oral evaluation - unknown +D0142,0.00,5.64,23.33,oral evaluation - unknown +D0143,0.00,4.74,45.00,oral evaluation - unknown +D0144,0.00,0.00,0.00,oral evaluation - unknown +D0145,0.00,3.17,100.00,oral evaluation for a patient under three years of age and counseling with primary caregiver +D0149,0.00,0.00,0.00,oral evaluation - unknown +D0150,0.00,271.18,45404.00,comprehensive oral evaluation - new or established patient +D0151,0.00,54.59,286.00,oral evaluation - unknown +D0152,0.00,25.33,60.50,oral evaluation - unknown +D0153,0.00,23.81,82.50,oral evaluation - unknown +D0154,0.00,82.61,2700.00,oral evaluation - unknown +D0155,0.00,161.20,1120.00,oral evaluation - unknown +D0156,0.00,17.75,354.60,oral evaluation - unknown +D0157,0.00,31.10,91.67,oral evaluation - unknown +D0158,0.00,22.50,62.50,oral evaluation - unknown +D0159,0.00,0.00,0.00,oral evaluation - unknown +D0160,0.00,16.01,5908.75,detailed and extensive oral evaluation - problem focused by report +D0161,0.00,25.00,50.00,oral evaluation - unknown +D0162,0.00,46.04,92.50,oral evaluation - unknown +D0163,0.00,10.65,42.61,oral evaluation - unknown +D0164,37.50,77.95,180.00,oral evaluation - unknown +D0168,0.00,0.00,0.00,oral evaluation - unknown +D0170,0.00,5.81,347.26,re-evaluation - limited problem focused (established patient; not post-operative visit) +D0171,0.00,9.27,103.00,re-evaluation - post-operative office visit +D0173,0.00,0.00,0.00,oral evaluation - unknown +D0177,0.00,37.50,150.00,oral evaluation - unknown +D0178,0.00,0.00,0.00,oral evaluation - unknown +D0179,0.00,0.00,0.00,oral evaluation - unknown +D0180,0.00,70.51,25169.00,comprehensive periodontal evaluation - new or established patient +D0181,0.00,0.00,0.00,oral evaluation - unknown +D0182,152.00,152.00,152.00,oral evaluation - unknown +D0183,0.00,0.00,0.00,oral evaluation - unknown +D0184,0.00,0.00,0.00,oral evaluation - unknown +D0185,0.00,0.00,0.00,oral evaluation - unknown +D0187,0.00,0.00,0.00,oral evaluation - unknown +D0188,0.00,0.00,0.00,oral evaluation - unknown +D0189,0.00,0.00,0.00,oral evaluation - unknown +D0190,0.00,12.92,4072.20,screening of a patient +D0191,0.00,1.23,169.00,assessment of a patient +D0193,0.01,6.76,13.51,oral evaluation - unknown +D0194,0.00,0.00,0.00,oral evaluation - unknown +D0195,0.00,0.00,0.00,oral evaluation - unknown +D0199,0.00,4.17,25.00,oral evaluation - unknown +D0200,0.00,22.76,430.00,radiographic imagery - unknown +D0201,0.00,1.56,1288.00,radiographic imagery - unknown +D0202,0.00,0.41,2915.00,radiographic imagery - unknown +D0203,0.00,0.00,1.00,radiographic imagery - unknown +D0204,0.00,2.41,65759.83,radiographic imagery - unknown +D0205,0.00,0.86,1669.00,radiographic imagery - unknown +D0206,0.00,0.00,1.00,radiographic imagery - unknown +D0207,0.00,0.88,3411.00,radiographic imagery - unknown +D0208,0.00,0.00,0.00,radiographic imagery - unknown +D0209,0.00,2.86,20.00,radiographic imagery - unknown +D0210,0.00,118.44,58471.00,intraoral - comprehensive series of radiographic images +D0211,0.00,0.00,0.00,radiographic imagery - unknown +D0213,0.00,0.00,0.00,radiographic imagery - unknown +D0214,0.00,35.50,71.00,radiographic imagery - unknown +D0216,0.00,0.00,0.00,radiographic imagery - unknown +D0219,202.00,202.00,202.00,radiographic imagery - unknown +D0220,0.00,62.12,47253.00,intraoral - periapical first radiographic image +D0221,0.00,0.00,0.00,radiographic imagery - unknown +D0222,0.00,0.00,0.00,radiographic imagery - unknown +D0223,0.00,0.00,0.00,radiographic imagery - unknown +D0224,0.00,0.00,0.00,radiographic imagery - unknown +D0229,0.00,0.00,0.00,radiographic imagery - unknown +D0230,0.00,18.17,16073.00,intraoral - periapical each additional radiographic image +D0231,0.00,0.00,0.00,radiographic imagery - unknown +D0232,0.00,0.00,0.00,radiographic imagery - unknown +D0233,0.00,57.13,450.00,radiographic imagery - unknown +D0235,0.00,0.00,0.00,radiographic imagery - unknown +D0237,0.00,0.00,0.00,radiographic imagery - unknown +D0238,17.00,17.00,17.00,radiographic imagery - unknown +D0240,0.00,43.51,5998.50,intraoral - occlusal radiographic image +D0241,0.00,0.00,0.00,radiographic imagery - unknown +D0247,0.00,550.00,1100.00,radiographic imagery - unknown +D0249,0.00,0.00,0.00,radiographic imagery - unknown +D0250,0.00,14.15,3231.00,extra-oral - 2D projection radiographic image created using a stationary radiation source and detector +D0251,0.00,5.54,72.00,extra-oral posterior dental radiographic image +D0257,1034.77,1626.85,2811.00,radiographic imagery - unknown +D0260,0.00,25.67,2314.00,radiographic imagery - unknown +D0261,0.00,0.00,0.00,radiographic imagery - unknown +D0263,0.00,0.00,0.00,radiographic imagery - unknown +D0265,0.00,0.00,0.00,radiographic imagery - unknown +D0270,0.00,142.88,24816.00,bitewing - single radiographic image +D0271,0.00,0.00,0.00,radiographic imagery - unknown +D0272,0.00,115.27,16848.00,bitewings - two radiographic images +D0273,0.00,68.60,6174.52,bitewings - three radiographic images +D0274,0.00,116.49,29639.00,bitewings - four radiographic images +D0275,0.00,0.00,0.00,radiographic imagery - unknown +D0277,0.00,300.14,6034.00,vertical bitewings - 7 to 8 radiographic images +D0279,0.00,108.24,180.40,radiographic imagery - unknown +D0280,0.00,0.00,0.00,radiographic imagery - unknown +D0281,26.88,26.88,26.88,radiographic imagery - unknown +D0283,0.00,28.74,145.00,radiographic imagery - unknown +D0288,0.00,0.00,0.00,radiographic imagery - unknown +D0289,0.00,0.00,0.00,radiographic imagery - unknown +D0290,0.00,7.74,500.00,radiographic imagery - unknown +D0293,0.00,0.00,0.00,radiographic imagery - unknown +D0294,0.00,0.00,0.00,radiographic imagery - unknown +D0295,0.00,0.00,0.00,radiographic imagery - unknown +D0299,0.00,132.90,4960.00,radiographic imagery - unknown +D0300,0.00,397.47,14823.63,other imagery - unknown +D0301,0.00,0.07,2400.00,other imagery - unknown +D0302,0.00,0.54,26412.34,other imagery - unknown +D0303,0.00,0.43,21117.04,other imagery - unknown +D0304,0.00,0.29,34977.58,other imagery - unknown +D0305,0.00,0.12,2773.27,other imagery - unknown +D0306,0.00,0.00,0.00,other imagery - unknown +D0307,0.00,0.00,0.00,other imagery - unknown +D0308,0.00,3.50,7.00,other imagery - unknown +D0310,0.00,0.00,0.00,sialography +D0311,0.00,0.00,0.00,other imagery - unknown +D0313,0.00,0.00,0.00,other imagery - unknown +D0317,0.00,0.00,0.00,other imagery - unknown +D0320,0.00,103.77,6610.00,temporomandibular joint arthrogram including injection +D0321,0.00,18.97,2421.00,other temporomandibular joint radiographic images by report +D0322,0.00,15.85,600.00,tomographic survey +D0323,0.00,0.00,0.00,other imagery - unknown +D0324,0.00,0.00,0.00,other imagery - unknown +D0325,0.00,0.00,0.00,other imagery - unknown +D0328,0.00,0.00,0.00,other imagery - unknown +D0330,0.00,11.01,22248.00,panoramic radiographic image +D0331,0.00,33.57,85.00,other imagery - unknown +D0332,0.00,0.00,0.00,other imagery - unknown +D0333,0.00,525.00,2100.00,other imagery - unknown +D0334,0.00,0.00,0.00,other imagery - unknown +D0335,0.00,0.00,0.00,other imagery - unknown +D0340,0.00,9.09,250.00,2D cephalometric radiographic image - acquisition measurement and analysis +D0343,0.00,0.00,0.00,other imagery - unknown +D0345,0.00,0.00,0.00,other imagery - unknown +D0347,0.00,0.00,0.00,other imagery - unknown +D0350,0.00,1.52,929.60,2D oral/facial photographic image obtained intra-orally or extra-orally +D0351,0.00,0.00,0.00,other imagery - unknown +D0353,0.00,0.00,0.00,other imagery - unknown +D0354,0.00,0.00,0.00,other imagery - unknown +D0355,0.00,5.43,125.00,other imagery - unknown +D0357,0.00,0.00,0.00,other imagery - unknown +D0359,0.00,0.00,0.00,other imagery - unknown +D0360,0.00,4.23,1213.00,other imagery - unknown +D0361,0.00,26.67,80.00,other imagery - unknown +D0362,0.00,0.00,0.00,other imagery - unknown +D0363,0.00,1.68,500.00,other imagery - unknown +D0364,0.00,1.90,387.00,cone beam CT capture and interpretation with limited field of view - less than one whole jaw +D0365,0.00,3.95,350.00,cone beam CT capture and interpretation with field of view of one full dental arch - mandible +D0366,0.00,3.09,398.21,cone beam CT capture and interpretation with field of view of one full dental arch - maxilla with or without cranium +D0367,0.00,5.11,818.79,cone beam CT capture and interpretation with field of view of both jaws; with or without cranium +D0368,0.00,1.10,350.00,cone beam CT capture and interpretation for TMJ series including two or more exposures +D0369,0.00,0.00,0.00,maxillofacial MRI capture and interpretation +D0370,0.00,0.00,0.00,maxillofacial ultrasound capture and interpretation +D0371,0.00,932.30,14871.00,sialoendoscopy capture and interpretation +D0372,0.00,0.00,0.00,intraoral tomosynthesis - comprehensive series of radiographic images +D0373,0.00,0.00,0.00,intraoral tomosynthesis - bitewing radiographic image +D0374,0.00,0.00,0.00,intraoral tomosynthesis - periapical radiographic image +D0376,0.00,131.50,263.00,other imagery - 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unknown +D0967,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0968,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0969,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0971,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0973,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0989,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0990,0.00,0.06,1.00,unspecified diagnostic procedure - unknown +D0991,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0992,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0994,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0996,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0997,0.00,0.00,0.00,unspecified diagnostic procedure - unknown +D0998,0.00,79.86,150.00,unspecified diagnostic procedure - unknown +D0999,0.00,68.43,6291.01,unspecified diagnostic procedure by report +D1000,0.00,0.00,0.00,diagnostic procedure - unknown +D1001,0.00,0.00,50.00,preventive procedure - unknown +D1002,0.00,0.00,1.00,preventive procedure - unknown +D1003,0.00,0.16,2897.00,preventive procedure - unknown +D1004,0.00,5.11,111147.35,preventive procedure - unknown +D1005,0.00,0.00,0.00,preventive procedure - unknown +D1006,0.00,0.00,0.00,preventive procedure - unknown +D1007,0.00,0.00,0.01,preventive procedure - unknown +D1008,0.00,0.00,0.00,preventive procedure - unknown +D1009,0.00,0.00,0.00,preventive procedure - unknown +D1010,0.00,0.00,0.00,preventive procedure - unknown +D1011,0.00,0.00,0.00,preventive procedure - unknown +D1012,0.00,0.00,0.00,preventive procedure - unknown +D1013,0.00,0.00,0.00,preventive procedure - unknown +D1014,0.00,0.00,0.00,preventive procedure - unknown +D1017,0.00,0.00,0.00,preventive procedure - unknown +D1019,0.00,0.00,0.00,preventive procedure - unknown +D1020,0.00,5.05,48.00,preventive procedure - unknown +D1022,0.00,1270.32,3387.53,preventive procedure - unknown +D1023,0.00,27.50,165.00,preventive procedure - unknown +D1024,0.00,0.00,0.00,preventive procedure - unknown +D1025,0.00,0.00,0.00,preventive procedure - unknown +D1026,0.00,0.00,0.00,preventive procedure - unknown +D1027,0.00,0.00,0.00,preventive procedure - unknown +D1028,0.00,0.00,0.00,preventive procedure - unknown +D1029,0.00,0.00,0.00,preventive procedure - unknown +D1030,0.00,74.17,445.00,preventive procedure - unknown +D1031,0.00,0.00,0.00,preventive procedure - unknown +D1033,0.00,0.00,0.00,preventive procedure - unknown +D1034,0.00,0.00,0.00,preventive procedure - unknown +D1038,0.00,0.00,0.00,preventive procedure - unknown +D1040,0.00,10.51,115.57,preventive procedure - unknown +D1042,0.00,327.25,1309.00,preventive procedure - unknown +D1043,0.00,0.00,0.00,preventive procedure - unknown +D1046,0.00,0.00,0.00,preventive procedure - unknown +D1050,0.00,18.00,90.00,preventive procedure - unknown +D1056,0.00,0.00,0.00,preventive procedure - unknown +D1059,0.00,0.00,0.00,preventive procedure - unknown +D1060,18.63,18.63,18.63,preventive procedure - unknown +D1073,0.00,0.00,0.00,preventive procedure - unknown +D1075,0.00,0.00,0.00,preventive procedure - unknown +D1076,0.00,0.00,0.00,preventive procedure - unknown +D1079,0.00,0.00,0.00,preventive procedure - unknown +D1080,0.00,0.00,0.00,preventive procedure - unknown +D1085,0.00,0.00,0.00,preventive procedure - unknown +D1089,0.00,0.00,0.00,preventive procedure - unknown +D1092,0.00,0.00,0.00,preventive procedure - unknown +D1093,0.00,0.00,0.00,preventive procedure - unknown +D1095,0.00,0.00,0.00,preventive procedure - unknown +D1099,0.00,0.00,0.00,preventive procedure - unknown +D1100,0.00,4.10,82.00,prophylaxis - unknown +D1101,0.00,0.00,1.00,prophylaxis - unknown +D1102,0.00,0.00,0.00,prophylaxis - unknown +D1103,0.00,0.00,0.00,prophylaxis - unknown +D1104,0.00,0.00,0.00,prophylaxis - unknown +D1105,0.00,0.00,0.00,prophylaxis - unknown +D1108,0.00,0.00,0.00,prophylaxis - unknown +D1110,0.00,81.39,137608.24,prophylaxis - adult +D1111,0.00,2.83,68.00,prophylaxis - unknown +D1112,0.00,0.00,0.00,prophylaxis - unknown +D1113,0.00,39.00,234.00,prophylaxis - unknown +D1115,0.00,0.00,0.00,prophylaxis - unknown +D1116,0.00,0.00,0.00,prophylaxis - unknown +D1118,0.00,0.00,0.00,prophylaxis - unknown +D1119,0.00,0.00,0.00,prophylaxis - unknown +D1120,0.00,128.76,48323.71,prophylaxis - child +D1123,0.00,0.00,0.00,prophylaxis - unknown +D1127,0.00,0.00,0.00,prophylaxis - unknown +D1130,0.00,0.00,0.00,prophylaxis - unknown +D1131,0.00,0.00,0.00,prophylaxis - unknown +D1139,0.00,0.00,0.00,prophylaxis - unknown +D1140,0.00,69.75,203.00,prophylaxis - unknown +D1146,0.00,0.00,0.00,prophylaxis - unknown +D1151,0.00,0.00,0.00,prophylaxis - unknown +D1155,0.00,0.00,0.00,prophylaxis - unknown +D1158,0.00,0.00,0.00,prophylaxis - unknown +D1161,0.00,0.00,0.00,prophylaxis - unknown +D1170,13.50,13.50,13.50,prophylaxis - unknown +D1173,0.00,0.00,0.00,prophylaxis - unknown +D1180,0.00,0.00,0.00,prophylaxis - unknown +D1190,0.00,0.00,0.00,prophylaxis - unknown +D1198,0.00,520.00,1300.00,prophylaxis - unknown +D1200,0.00,200.00,2000.00,topical application of fluoride - unknown +D1201,0.00,0.00,0.01,topical application of fluoride - unknown +D1202,0.00,0.00,0.00,topical application of fluoride - unknown +D1203,0.00,2.00,7612.50,topical application of fluoride - unknown +D1204,0.00,30.44,8286.00,topical application of fluoride - unknown +D1205,0.00,3.79,251.80,topical application of fluoride - unknown +D1206,0.00,165.69,39312.00,topical application of fluoride varnish +D1207,12.00,12.00,12.00,topical application of fluoride - unknown +D1208,0.00,145.45,13946.00,topical application of fluoride - excluding varnish +D1210,0.00,5.41,265.00,topical application of fluoride - unknown +D1213,0.00,0.00,0.00,topical application of fluoride - unknown +D1214,0.00,0.00,0.00,topical application of fluoride - unknown +D1215,0.00,0.00,0.00,topical application of fluoride - unknown +D1220,0.00,0.00,0.00,topical application of fluoride - unknown +D1223,0.00,0.00,0.00,topical application of fluoride - unknown +D1226,0.00,0.00,0.00,topical application of fluoride - unknown +D1230,0.00,0.00,0.00,topical application of fluoride - unknown +D1232,0.00,0.00,0.00,topical application of fluoride - unknown +D1233,0.00,0.00,0.00,topical application of fluoride - unknown +D1235,0.00,0.00,0.00,topical application of fluoride - unknown +D1237,0.00,0.00,0.00,topical application of fluoride - unknown +D1240,0.00,56.59,282.94,topical application of fluoride - unknown +D1246,0.00,0.00,0.00,topical application of fluoride - unknown +D1248,0.00,0.00,0.00,topical application of fluoride - unknown +D1249,0.00,0.00,0.00,topical application of fluoride - unknown +D1250,0.00,150.42,227.00,topical application of fluoride - unknown +D1256,300.00,300.00,300.00,topical application of fluoride - unknown +D1260,0.00,0.00,0.00,topical application of fluoride - unknown +D1267,250.03,250.03,250.03,topical application of fluoride - unknown +D1274,0.00,0.00,0.00,topical application of fluoride - unknown +D1275,3134.40,3134.40,3134.40,topical application of fluoride - unknown +D1291,0.00,0.00,0.00,topical application of fluoride - unknown +D1299,0.00,343.75,1375.00,topical application of fluoride - unknown +D1300,0.00,54.61,163.82,preventative measure - unknown +D1301,0.00,0.00,1.00,preventative measure - unknown +D1302,0.00,0.00,0.00,preventative measure - unknown +D1303,0.00,0.00,1.00,preventative measure - unknown +D1304,0.00,0.00,0.00,preventative measure - unknown +D1305,0.00,0.00,0.00,preventative measure - unknown +D1307,0.00,0.00,0.00,preventative measure - unknown +D1310,0.00,25.16,5666.84,nutritional counseling for control of dental disease +D1312,0.00,0.00,0.00,preventative measure - unknown +D1320,0.00,0.70,479.00,tobacco counseling for the control and prevention of oral disease +D1330,0.00,13.64,5666.82,oral hygiene instructions +D1331,0.00,0.00,0.00,preventative measure - unknown +D1332,0.00,59.09,250.00,preventative measure - unknown +D1333,0.00,0.00,0.00,preventative measure - unknown +D1340,0.00,0.00,0.00,preventative measure - unknown +D1351,0.00,186.19,10926.75,sealant - per tooth +D1352,0.00,92.08,1077.67,preventive resin restoration in a moderate to high caries risk patient - permanent tooth +D1353,0.00,150.69,9958.00,sealant repair - per tooth +D1354,0.00,66.89,3939.18,application of caries arresting medicament - per tooth +D1355,0.00,0.00,0.00,caries preventive medicament application - per tooth +D1357,0.00,0.00,0.00,preventative measure - unknown +D1360,0.00,0.00,0.00,preventative measure - unknown +D1382,0.00,0.00,0.00,preventative measure - unknown +D1390,0.00,0.00,0.00,preventative measure - unknown +D1392,0.00,0.00,0.00,preventative measure - unknown +D1399,0.00,0.00,0.00,preventative measure - unknown +D1400,0.00,145.78,1312.00,preventive procedure - unknown +D1401,0.00,1.90,6662.00,preventive procedure - unknown +D1402,0.00,0.20,1520.00,preventive procedure - unknown +D1403,0.00,0.59,5981.33,preventive procedure - unknown +D1404,0.00,0.43,5375.23,preventive procedure - unknown +D1407,0.00,0.00,0.00,preventive procedure - unknown +D1408,0.00,0.00,0.00,preventive procedure - unknown +D1409,0.00,0.00,0.00,preventive procedure - unknown +D1410,0.00,42.38,339.00,preventive procedure - unknown +D1414,0.00,0.00,0.00,preventive procedure - unknown +D1415,0.00,0.00,0.00,preventive procedure - unknown +D1425,0.00,0.00,0.00,preventive procedure - unknown +D1440,0.00,117.50,352.51,preventive procedure - unknown +D1441,0.00,0.00,0.00,preventive procedure - unknown +D1442,0.00,0.00,0.00,preventive procedure - unknown +D1450,0.00,0.00,0.00,preventive procedure - unknown +D1467,262.00,262.00,262.00,preventive procedure - unknown +D1470,0.00,0.00,0.00,preventive procedure - unknown +D1474,1000.00,1000.00,1000.00,preventive procedure - unknown +D1479,0.00,13.45,296.00,preventive procedure - unknown +D1480,0.00,248.27,2296.00,preventive procedure - unknown +D1482,0.00,0.00,0.00,preventive procedure - unknown +D1497,0.00,0.00,0.00,preventive procedure - unknown +D1499,0.00,0.00,0.00,preventive procedure - unknown +D1500,0.00,0.00,0.00,space maintainer - unknown +D1501,0.00,3.19,12052.73,space maintainer - unknown +D1502,0.00,0.37,6410.00,space maintainer - unknown +D1503,0.00,0.00,0.01,space maintainer - unknown +D1504,0.00,0.31,1198.00,space maintainer - unknown +D1509,0.00,0.00,0.00,space maintainer - unknown +D1510,0.00,0.00,0.00,space maintainer - fixed unilateral - per quadrant +D1511,0.00,0.00,0.00,space maintainer - unknown +D1513,0.00,0.00,0.00,space maintainer - unknown +D1515,0.00,0.00,0.00,space maintainer - unknown +D1516,0.00,0.00,0.00,space maintainer - fixed - bilateral maxillary +D1517,0.00,0.00,0.00,space maintainer - fixed - bilateral mandibular +D1520,0.00,22.93,172.00,space maintainer - removable unilateral - per quadrant +D1525,0.00,132.50,265.00,space maintainer - unknown +D1526,0.00,0.00,0.00,space maintainer - removable - bilateral maxillary +D1530,0.00,0.00,0.00,space maintainer - unknown +D1548,0.00,0.00,0.00,space maintainer - unknown +D1550,0.00,0.00,0.00,space maintainer - unknown +D1551,0.00,0.00,0.00,re-cement or re-bond bilateral space maintainer - maxillary +D1555,0.00,0.00,0.00,space maintainer - unknown +D1560,0.00,0.00,0.00,space maintainer - unknown +D1573,0.00,0.00,0.00,space maintainer - unknown +D1574,0.00,0.00,0.00,space maintainer - unknown +D1600,0.00,0.00,0.00,preventive procedure - unknown +D1601,0.00,0.00,0.00,preventive procedure - unknown +D1602,0.00,0.00,1.00,preventive procedure - unknown +D1603,0.00,0.62,1288.00,preventive procedure - unknown +D1604,0.00,0.00,0.00,preventive procedure - unknown +D1619,0.00,0.00,0.00,preventive procedure - unknown +D1620,40.00,40.00,40.00,preventive procedure - unknown +D1628,0.00,0.00,0.00,preventive procedure - unknown +D1630,19.76,19.76,19.76,preventive procedure - unknown +D1642,0.21,0.21,0.21,preventive procedure - unknown +D1644,1.20,1.20,1.20,preventive procedure - unknown +D1646,0.00,0.00,0.00,preventive procedure - unknown +D1688,0.00,0.00,0.00,preventive procedure - unknown +D1701,0.00,0.27,1181.71,Pfizer-BioNTech Covid-19 vaccine administration - first dose +D1702,0.00,0.74,6696.00,Pfizer-BioNTech Covid-19 vaccine administration - second dose +D1703,0.00,0.66,2917.91,Moderna Covid-19 vaccine administration - first dose +D1704,0.00,0.13,2098.11,Moderna Covid-19 vaccine administration - second dose +D1705,0.00,0.20,1936.00,AstraZeneca Covid-19 vaccine administration - first dose +D1707,50.00,50.00,50.00,Janssen Covid-19 vaccine administration +D1709,0.00,0.00,0.00,Pfizer-BioNTech Covid-19 vaccine administration - booster dose +D1710,0.00,0.00,0.00,Moderna Covid-19 vaccine administration - third dose +D1711,0.00,0.00,0.00,Moderna Covid-19 vaccine administration - booster dose +D1713,1737.50,1737.50,1737.50,Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - first dose +D1714,0.00,25.71,180.00,Pfizer-BioNTech Covid-19 vaccine administration tris-sucrose pediatric - second dose +D1716,0.00,0.00,0.00,vaccine administration - unknown +D1720,0.00,0.00,0.00,vaccine administration - unknown +D1721,0.00,0.00,0.00,vaccine administration - unknown +D1723,0.00,0.00,0.00,vaccine administration - unknown +D1729,615.60,615.60,615.60,vaccine administration - unknown +D1730,0.00,0.00,0.00,vaccine administration - unknown +D1732,21469.00,21469.00,21469.00,vaccine administration - unknown +D1740,0.00,581.34,27100.00,vaccine administration - unknown +D1741,0.00,0.00,0.00,vaccine administration - unknown +D1758,72.31,72.31,72.31,vaccine administration - unknown +D1760,682.00,682.00,682.00,vaccine administration - unknown +D1769,100.00,880.00,1559.40,vaccine administration - unknown +D1778,2723.00,2723.00,2723.00,vaccine administration - unknown +D1799,0.00,0.00,0.00,vaccine administration - unknown +D1801,0.00,0.20,171.00,preventive procedure - unknown +D1802,0.00,0.00,0.00,preventive procedure - unknown +D1803,0.00,0.19,775.00,preventive procedure - unknown +D1804,0.00,0.00,0.00,preventive procedure - unknown +D1805,0.00,0.00,0.00,preventive procedure - unknown +D1806,0.00,0.00,0.00,preventive procedure - unknown +D1810,0.00,112.84,656.00,preventive procedure - unknown +D1819,0.00,0.00,0.00,preventive procedure - unknown +D1820,0.00,202.83,811.33,preventive procedure - unknown +D1830,0.00,90.81,984.00,preventive procedure - unknown +D1844,0.00,0.00,0.00,preventive procedure - unknown +D1851,0.00,0.00,0.00,preventive procedure - unknown +D1874,0.00,92.50,462.50,preventive procedure - unknown +D1880,0.00,0.00,0.00,preventive procedure - unknown +D1885,0.00,0.00,0.00,preventive procedure - unknown +D1887,2012.50,2012.50,2012.50,preventive procedure - unknown +D1894,182.00,182.00,182.00,preventive procedure - unknown +D1895,12490.00,12490.00,12490.00,preventive procedure - unknown +D1897,5285.00,5285.00,5285.00,preventive procedure - unknown +D1898,1033.00,1033.00,1033.00,preventive procedure - unknown +D1899,0.00,0.00,0.00,preventive procedure - unknown +D1900,0.00,37.50,75.00,unspecified preventive procedure - unknown +D1901,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1902,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1903,0.00,0.00,0.33,unspecified preventive procedure - unknown +D1904,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1916,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1919,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1922,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1944,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1953,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1961,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1970,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1971,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1975,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1989,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1991,0.00,375.00,750.00,unspecified preventive procedure - unknown +D1992,0.00,251.01,2065.00,unspecified preventive procedure - unknown +D1996,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1998,0.00,0.00,0.00,unspecified preventive procedure - unknown +D1999,0.00,3.63,937.09,unspecified preventive procedure by report +D2000,0.00,0.00,0.00,preventive procedure - unknown +D2001,0.00,0.16,2204.00,restorative procedure - unknown +D2002,0.00,0.59,43425.03,restorative procedure - unknown +D2003,0.00,0.55,47139.07,restorative procedure - unknown +D2004,0.00,0.44,17082.12,restorative procedure - unknown +D2005,0.00,0.45,2859.00,restorative procedure - unknown +D2006,0.00,0.00,0.00,restorative procedure - unknown +D2007,0.00,0.00,0.00,restorative procedure - unknown +D2008,0.00,0.00,0.00,restorative procedure - unknown +D2010,0.00,0.00,0.00,restorative procedure - unknown +D2011,0.00,27.67,83.00,restorative procedure - unknown +D2012,0.00,5.25,42.00,restorative procedure - unknown +D2014,0.00,0.00,0.00,restorative procedure - unknown +D2020,0.00,0.00,0.00,restorative procedure - unknown +D2021,0.00,0.00,0.00,restorative procedure - unknown +D2022,0.00,0.00,0.00,restorative procedure - unknown +D2023,0.00,0.00,0.00,restorative procedure - unknown +D2024,0.00,12.73,25.46,restorative procedure - unknown +D2025,0.00,43.64,138.00,restorative procedure - unknown +D2027,0.00,0.00,0.00,restorative procedure - unknown +D2033,0.00,0.00,0.00,restorative procedure - unknown +D2035,0.00,0.00,0.00,restorative procedure - unknown +D2036,0.00,15.00,25.00,restorative procedure - unknown +D2037,0.00,37.37,84.50,restorative procedure - unknown +D2038,0.00,15.66,41.89,restorative procedure - unknown +D2039,20.00,20.00,20.00,restorative procedure - unknown +D2043,37.30,66.53,125.00,restorative procedure - unknown +D2044,0.00,0.00,0.00,restorative procedure - unknown +D2050,0.00,0.00,0.00,restorative procedure - unknown +D2052,0.00,0.00,0.00,restorative procedure - unknown +D2055,0.00,0.00,0.00,restorative procedure - unknown +D2066,0.00,0.00,0.00,restorative procedure - unknown +D2070,0.00,0.00,0.00,restorative procedure - unknown +D2072,0.00,0.00,0.00,restorative procedure - unknown +D2074,0.00,37.50,75.00,restorative procedure - unknown +D2083,0.00,0.00,0.00,restorative procedure - unknown +D2090,0.00,466.67,750.00,restorative procedure - unknown +D2099,0.00,0.00,0.00,restorative procedure - unknown +D2100,0.00,0.00,0.00,amalgam - unknown +D2101,0.00,0.00,0.50,amalgam - unknown +D2102,0.00,0.00,0.00,amalgam - unknown +D2103,0.00,0.00,0.00,amalgam - unknown +D2104,0.00,0.00,0.00,amalgam - unknown +D2105,0.00,0.00,0.00,amalgam - unknown +D2106,0.00,0.00,0.00,amalgam - unknown +D2108,0.00,0.00,0.00,amalgam - unknown +D2110,0.00,54.05,1250.00,amalgam - unknown +D2111,0.00,0.00,0.00,amalgam - unknown +D2112,0.00,0.00,0.00,amalgam - unknown +D2115,0.00,0.00,0.00,amalgam - unknown +D2119,0.00,0.00,0.00,amalgam - unknown +D2120,0.00,22.57,158.00,amalgam - unknown +D2121,0.00,150.00,1200.00,amalgam - unknown +D2122,0.00,0.00,0.00,amalgam - unknown +D2123,0.00,0.00,0.00,amalgam - unknown +D2124,0.00,0.00,0.00,amalgam - unknown +D2127,0.00,0.00,0.00,amalgam - unknown +D2129,0.00,0.00,0.00,amalgam - unknown +D2130,0.00,0.00,0.00,amalgam - unknown +D2131,0.00,0.00,0.00,amalgam - unknown +D2134,79.00,79.00,79.00,amalgam - unknown +D2136,0.00,0.00,0.00,amalgam - unknown +D2140,0.00,169.73,58134.00,amalgam - one surface primary or permanent +D2141,0.00,0.00,0.00,amalgam - unknown +D2145,0.00,0.00,0.00,amalgam - unknown +D2146,0.00,0.00,0.00,amalgam - unknown +D2150,0.00,121.51,27223.33,amalgam - two surfaces primary or permanent +D2151,0.00,0.00,0.00,amalgam - unknown +D2154,0.00,0.00,0.00,amalgam - unknown +D2160,0.00,132.82,48988.80,amalgam - three surfaces primary or permanent +D2161,0.00,224.23,32236.00,amalgam - four or more surfaces primary or permanent +D2163,0.00,0.00,0.00,amalgam - unknown +D2166,0.00,0.00,0.00,amalgam - unknown +D2180,0.00,0.00,0.00,amalgam - unknown +D2199,0.00,0.00,0.00,amalgam - unknown +D2200,0.00,0.00,0.00,restorative procedure - unknown +D2203,0.00,0.00,0.00,restorative procedure - unknown +D2204,0.00,0.00,0.00,restorative procedure - unknown +D2210,0.00,0.00,0.00,restorative procedure - unknown +D2211,0.00,0.00,0.00,restorative procedure - unknown +D2212,0.00,0.00,0.00,restorative procedure - unknown +D2217,0.00,0.00,0.00,restorative procedure - unknown +D2220,0.00,24.56,442.00,restorative procedure - unknown +D2221,0.00,20.78,187.00,restorative procedure - unknown +D2222,0.00,0.00,0.00,restorative procedure - unknown +D2223,0.00,0.00,0.00,restorative procedure - unknown +D2225,0.00,0.00,0.00,restorative procedure - unknown +D2230,0.00,494.17,4004.00,restorative procedure - unknown +D2231,0.00,35.51,532.66,restorative procedure - unknown +D2233,0.00,0.00,0.00,restorative procedure - unknown +D2235,0.00,1187.85,6165.66,restorative procedure - unknown +D2248,0.00,0.00,0.00,restorative procedure - unknown +D2250,0.00,20.49,71.70,restorative procedure - unknown +D2261,0.00,0.00,0.00,restorative procedure - unknown +D2270,0.00,74.47,572.00,restorative procedure - unknown +D2274,0.00,0.00,0.00,restorative procedure - unknown +D2275,0.00,0.00,0.00,restorative procedure - unknown +D2293,0.00,0.00,0.00,restorative procedure - unknown +D2300,0.00,0.00,0.00,resin-based composite - unknown +D2302,0.00,0.00,0.00,resin-based composite - unknown +D2306,0.00,0.00,0.00,resin-based composite - unknown +D2309,0.00,0.00,0.00,resin-based composite - unknown +D2310,0.00,0.00,0.00,resin-based composite - unknown +D2311,0.00,118.55,268.00,resin-based composite - unknown +D2314,0.00,0.00,0.00,resin-based composite - unknown +D2318,0.00,0.00,0.00,resin-based composite - unknown +D2322,0.00,0.00,0.00,resin-based composite - unknown +D2323,0.00,0.00,0.00,resin-based composite - unknown +D2325,0.00,0.00,0.00,resin-based composite - unknown +D2328,0.00,0.00,0.00,resin-based composite - unknown +D2329,0.00,0.00,0.00,resin-based composite - unknown +D2330,0.00,121.44,25470.50,resin-based composite - one surface anterior +D2331,0.00,99.23,19964.00,resin-based composite - two surfaces anterior +D2332,0.00,88.01,10394.00,resin-based composite - three surfaces anterior +D2333,0.00,49.57,347.00,resin-based composite - unknown +D2335,0.00,146.45,19000.00,resin-based composite - four or more surfaces or involving incisal angle (anterior) +D2336,0.00,142.50,285.00,resin-based composite - unknown +D2337,0.00,0.00,0.00,resin-based composite - unknown +D2340,0.00,0.00,0.00,resin-based composite - unknown +D2343,0.00,183.75,245.00,resin-based composite - unknown +D2347,0.00,0.00,0.00,resin-based composite - unknown +D2350,0.00,0.00,0.00,resin-based composite - unknown +D2351,0.00,0.00,0.00,resin-based composite - unknown +D2352,0.00,0.00,0.00,resin-based composite - unknown +D2355,0.00,0.00,0.00,resin-based composite - unknown +D2362,0.00,0.00,0.00,resin-based composite - unknown +D2365,0.00,0.00,0.00,resin-based composite - unknown +D2367,0.00,0.00,0.00,resin-based composite - unknown +D2370,0.00,0.00,0.00,resin-based composite - unknown +D2374,28.00,28.00,28.00,resin-based composite - unknown +D2375,97.00,97.00,97.00,resin-based composite - unknown +D2380,0.00,0.00,0.00,resin-based composite - unknown +D2381,0.00,0.42,5.00,resin-based composite - unknown +D2382,0.00,0.00,0.00,resin-based composite - unknown +D2383,0.00,0.00,0.00,resin-based composite - unknown +D2385,0.00,3.62,69.69,resin-based composite - unknown +D2386,0.00,2.66,100.96,resin-based composite - unknown +D2387,0.00,0.00,0.00,resin-based composite - unknown +D2388,0.00,0.00,0.00,resin-based composite - unknown +D2390,0.00,431.16,13175.00,resin-based composite crown anterior +D2391,0.00,174.32,24903.00,resin-based composite - one surface posterior +D2392,0.00,145.87,35421.00,resin-based composite - two surfaces posterior +D2393,0.00,145.68,19556.61,resin-based composite - three surfaces posterior +D2394,0.00,254.96,29784.25,resin-based composite - four or more surfaces posterior +D2397,0.00,0.00,0.00,resin-based composite - unknown +D2400,0.00,0.00,0.00,gold foil - unknown +D2401,0.00,0.00,0.00,gold foil - unknown +D2402,0.00,0.00,0.00,gold foil - unknown +D2403,0.00,0.00,0.00,gold foil - unknown +D2404,0.00,0.00,0.00,gold foil - unknown +D2405,0.00,4.17,9.92,gold foil - unknown +D2406,0.00,0.00,0.00,gold foil - unknown +D2407,0.00,0.00,0.00,gold foil - unknown +D2410,0.00,630.27,4727.00,gold foil - one surface +D2426,0.00,0.00,0.00,gold foil - unknown +D2430,0.00,0.00,0.00,gold foil - three surfaces +D2432,0.00,0.00,0.00,gold foil - unknown +D2438,0.00,0.00,0.00,gold foil - unknown +D2450,0.00,0.00,0.00,gold foil - unknown +D2455,0.00,0.00,0.00,gold foil - unknown +D2461,0.00,0.00,0.00,gold foil - unknown +D2463,0.00,0.00,0.00,gold foil - unknown +D2465,0.00,0.00,0.00,gold foil - unknown +D2466,0.00,0.00,0.00,gold foil - unknown +D2470,0.00,0.00,0.00,gold foil - unknown +D2490,0.00,0.00,0.00,gold foil - unknown +D2491,0.00,0.00,0.00,gold foil - unknown +D2496,0.00,0.00,0.00,gold foil - unknown +D2499,0.00,0.00,0.00,gold foil - unknown +D2501,0.00,78.98,315.91,inlay or onlay - metallic - unknown +D2507,117.25,117.25,117.25,inlay or onlay - metallic - unknown +D2510,0.00,1530.17,8160.00,inlay - metallic - one surface +D2511,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2514,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2520,0.00,0.00,0.00,inlay - metallic - two surfaces +D2526,160.00,219.50,279.00,inlay or onlay - metallic - unknown +D2532,585.90,585.90,585.90,inlay or onlay - metallic - unknown +D2537,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2540,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2542,0.00,0.00,0.00,onlay - metallic - two surfaces +D2543,0.00,273.00,1365.00,onlay - metallic - three surfaces +D2544,0.00,3351.40,32148.00,onlay - metallic - four or more surfaces +D2550,0.00,36.06,131.00,inlay or onlay - metallic - unknown +D2553,0.00,8.80,44.00,inlay or onlay - metallic - unknown +D2557,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2565,168.62,168.62,168.62,inlay or onlay - metallic - unknown +D2570,6.85,6.85,6.85,inlay or onlay - metallic - unknown +D2571,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2572,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2574,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2576,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2579,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2591,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2592,0.00,0.00,0.00,inlay or onlay - metallic - unknown +D2603,0.00,0.00,0.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2605,0.00,0.00,0.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2607,0.00,281.54,492.69,inlay or onlay - porcelain/ceramic/resin - unknown +D2610,0.00,226.47,2750.17,inlay - porcelain/ceramic - one surface +D2611,0.00,0.00,0.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2613,0.00,0.00,0.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2620,0.00,0.00,0.01,inlay - porcelain/ceramic - two surfaces +D2622,0.00,0.00,0.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2630,0.00,68.93,1567.14,inlay - porcelain/ceramic - three or more surfaces +D2632,300.00,300.00,300.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2642,0.00,0.00,0.00,onlay - porcelain/ceramic - two surfaces +D2643,0.00,0.08,1.00,onlay - porcelain/ceramic - three surfaces +D2644,0.00,148.10,7792.50,onlay - porcelain/ceramic - four or more surfaces +D2650,0.00,678.81,20081.00,inlay - resin-based composite - one surface +D2651,0.00,26.25,1575.00,inlay - resin-based composite - two surfaces +D2652,0.00,663.67,4550.00,inlay - resin-based composite - three or more surfaces +D2654,0.00,144.00,288.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2662,0.00,529.74,8620.32,onlay - resin-based composite - two surfaces +D2663,0.00,147.57,1442.00,onlay - resin-based composite - three surfaces +D2664,0.00,130.73,1548.00,onlay - resin-based composite - four or more surfaces +D2677,0.00,0.00,0.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2691,0.00,0.00,0.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2692,0.00,70.00,350.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2699,0.00,0.00,0.00,inlay or onlay - porcelain/ceramic/resin - unknown +D2700,0.00,3.90,63.00,crown - unknown +D2701,0.00,0.00,0.00,crown - unknown +D2703,0.00,10.00,25.00,crown - unknown +D2704,0.00,0.00,0.00,crown - unknown +D2706,0.00,0.00,0.00,crown - unknown +D2709,0.00,0.00,0.00,crown - unknown +D2710,0.00,165.11,13552.00,crown - resin-based composite (indirect) +D2711,0.00,0.00,0.00,crown - unknown +D2712,0.00,0.00,0.00,crown - ¾ resin-based composite (indirect) +D2713,0.00,0.00,0.00,crown - unknown +D2715,0.00,0.00,0.00,crown - unknown +D2718,0.00,0.00,0.00,crown - unknown +D2720,0.00,114.55,1260.00,crown - resin with high noble metal +D2721,0.00,0.00,0.00,crown - resin with predominantly base metal +D2722,0.00,0.50,1.00,crown - resin with noble metal +D2728,367.25,367.25,367.25,crown - unknown +D2729,0.00,0.00,0.00,crown - unknown +D2730,0.00,0.00,0.00,crown - unknown +D2739,0.00,0.00,0.00,crown - unknown +D2740,0.00,33.00,18577.00,crown - porcelain/ceramic +D2741,0.00,110.67,664.00,crown - unknown +D2744,0.00,0.00,0.00,crown - unknown +D2745,0.00,0.00,0.00,crown - unknown +D2746,0.00,65.50,131.00,crown - unknown +D2749,0.00,0.00,0.00,crown - unknown +D2750,0.00,35.52,3200.00,crown - porcelain fused to high noble metal +D2751,0.00,52.07,2190.51,crown - porcelain fused to predominantly base metal +D2752,0.00,40.62,11872.04,crown - porcelain fused to noble metal +D2753,0.00,0.00,0.00,crown - porcelain fused to titanium and titanium alloys +D2754,0.00,0.00,0.00,crown - unknown +D2755,0.00,0.00,0.00,crown - unknown +D2756,0.00,0.00,0.00,crown - unknown +D2760,0.00,0.00,0.00,crown - unknown +D2761,0.00,0.00,0.00,crown - unknown +D2764,0.00,0.00,0.00,crown - unknown +D2771,0.00,0.00,0.00,crown - unknown +D2777,0.00,0.00,0.00,crown - unknown +D2780,0.00,218.51,1311.07,crown - 3/4 cast high noble metal +D2781,0.00,0.00,0.00,crown - 3/4 cast predominantly base metal +D2782,0.00,0.00,0.00,crown - 3/4 cast noble metal +D2783,0.00,0.00,0.00,crown - 3/4 porcelain/ceramic +D2784,0.00,0.00,0.00,crown - unknown +D2786,0.00,0.00,0.00,crown - unknown +D2788,0.00,0.00,0.00,crown - unknown +D2790,0.00,11.38,1162.37,crown - full cast high noble metal +D2791,0.00,21.62,600.00,crown - full cast predominantly base metal +D2792,0.00,50.51,1240.05,crown - full cast noble metal +D2794,0.00,0.00,0.00,crown - titanium and titanium alloys +D2795,0.00,0.00,0.00,crown - unknown +D2798,0.00,0.00,0.00,crown - unknown +D2799,0.00,50.37,3248.40,interim crown - further treatment or completion of diagnosis necessary prior to final impression +D2820,0.00,0.00,0.00,restorative procedure - unknown +D2837,0.00,0.00,0.00,restorative procedure - unknown +D2840,0.00,8.57,120.00,restorative procedure - unknown +D2841,0.00,0.00,0.00,restorative procedure - unknown +D2846,0.00,0.00,0.00,restorative procedure - unknown +D2849,0.00,0.00,0.00,restorative procedure - unknown +D2850,0.00,0.00,0.00,restorative procedure - unknown +D2886,0.00,0.00,0.00,restorative procedure - unknown +D2889,0.00,0.00,0.00,restorative procedure - unknown +D2890,0.00,0.00,0.00,restorative procedure - unknown +D2891,0.00,0.00,0.00,restorative procedure - unknown +D2892,0.00,0.00,0.00,restorative procedure - unknown +D2899,0.00,0.00,0.00,restorative procedure - unknown +D2900,0.00,0.00,0.00,restoration or repair - unknown +D2910,0.00,591.30,15008.50,re-cement or re-bond inlay onlay veneer or partial coverage restoration +D2911,0.00,0.00,0.00,restoration or repair - unknown +D2915,0.00,263.88,1440.00,re-cement or re-bond indirectly fabricated or prefabricated post and core +D2920,0.00,15.79,10734.50,re-cement or re-bond crown +D2921,0.00,73.98,641.20,reattachment of tooth fragment incisal edge or cusp +D2922,0.00,0.00,0.00,restoration or repair - unknown +D2928,0.00,1.20,2.00,prefabricated porcelain/ceramic crown - permanent tooth +D2929,0.00,0.00,0.00,prefabricated porcelain/ceramic crown - primary tooth +D2930,0.00,320.24,15627.50,prefabricated stainless steel crown - primary tooth +D2931,0.00,226.26,16000.00,prefabricated stainless steel crown - permanent tooth +D2932,0.00,87.32,5249.33,prefabricated resin crown +D2933,0.00,224.94,7557.73,prefabricated stainless steel crown with resin window +D2934,0.00,0.08,1.00,prefabricated esthetic coated stainless steel crown - primary tooth +D2935,0.00,0.00,0.00,restoration or repair - unknown +D2939,0.00,52.50,210.00,restoration or repair - unknown +D2940,0.00,546.34,26863.00,protective restoration +D2941,0.00,916.84,7896.67,interim therapeutic restoration - primary dentition +D2944,0.00,0.00,0.00,restoration or repair - unknown +D2945,0.00,0.00,0.00,restoration or repair - unknown +D2947,0.00,44.22,108.88,restoration or repair - unknown +D2948,0.00,0.00,0.00,restoration or repair - unknown +D2949,0.00,0.00,0.00,restorative foundation for an indirect restoration +D2950,0.00,10.17,11716.00,core buildup including any pins when required +D2951,0.00,10.99,275.00,pin retention - per tooth in addition to restoration +D2952,0.00,10.96,1883.33,post and core in addition to crown indirectly fabricated +D2953,0.00,96.11,480.55,each additional indirectly fabricated post - same tooth +D2954,0.00,8.70,718.00,prefabricated post and core in addition to crown +D2955,0.00,47.04,4422.00,post removal +D2957,0.00,28.18,155.00,each additional prefabricated post - same tooth +D2959,0.00,0.00,0.00,restoration or repair - unknown +D2960,0.00,27.48,1211.75,labial veneer (resin laminate) - direct +D2961,0.00,29.06,177.00,labial veneer (resin laminate) - indirect +D2962,0.00,9.88,1822.00,labial veneer (porcelain laminate) - indirect +D2964,0.00,0.00,0.00,restoration or repair - unknown +D2965,0.00,21.43,300.00,restoration or repair - unknown +D2970,0.00,42.01,3843.35,restoration or repair - unknown +D2971,0.00,0.01,1.00,additional procedures to customize a crown to fit under an existing partial denture framework +D2975,0.00,0.00,0.00,coping +D2979,0.00,0.00,0.00,restoration or repair - unknown +D2980,0.00,11.63,305.00,crown repair necessitated by restorative material failure +D2981,0.00,0.00,0.00,inlay repair necessitated by restorative material failure +D2982,0.00,0.00,0.00,onlay repair necessitated by restorative material failure +D2983,0.00,0.00,0.00,veneer repair necessitated by restorative material failure +D2990,0.00,62.72,2320.66,resin infiltration of incipient smooth surface lesions +D2991,0.00,0.00,0.00,restoration or repair - unknown +D2992,0.00,0.00,0.00,restoration or repair - unknown +D2997,0.00,50.00,75.00,restoration or repair - unknown +D2998,0.00,0.00,0.00,restoration or repair - unknown +D2999,0.00,466.28,45200.00,unspecified restorative procedure by report +D3000,0.00,0.00,0.00,restorative procedure - unknown +D3001,0.00,0.00,0.00,endodontics procedure - unknown +D3002,0.00,45.00,90.00,endodontics procedure - unknown +D3003,0.00,0.00,0.00,endodontics procedure - unknown +D3005,0.00,116.00,145.00,endodontics procedure - unknown +D3010,0.00,12.86,64.48,endodontics procedure - unknown +D3016,0.00,0.00,0.00,endodontics procedure - unknown +D3020,0.00,0.00,0.00,endodontics procedure - unknown +D3024,0.00,0.00,0.00,endodontics procedure - unknown +D3026,0.00,0.00,0.00,endodontics procedure - unknown +D3027,0.00,0.00,0.00,endodontics procedure - unknown +D3029,0.00,0.00,0.00,endodontics procedure - unknown +D3030,0.00,0.00,0.00,endodontics procedure - unknown +D3031,0.00,0.00,0.00,endodontics procedure - unknown +D3036,0.00,0.00,0.00,endodontics procedure - unknown +D3037,0.00,0.00,0.00,endodontics procedure - unknown +D3044,0.00,0.00,0.00,endodontics procedure - unknown +D3058,0.00,0.00,0.00,endodontics procedure - unknown +D3059,0.00,0.00,0.00,endodontics procedure - unknown +D3065,0.00,0.00,0.00,endodontics procedure - unknown +D3067,0.00,0.00,0.00,endodontics procedure - unknown +D3072,0.00,0.00,0.00,endodontics procedure - unknown +D3090,0.00,0.00,0.00,endodontics procedure - unknown +D3100,0.00,0.00,0.00,pulp cap - unknown +D3102,0.00,0.00,0.00,pulp cap - unknown +D3109,0.00,0.00,0.00,pulp cap - unknown +D3110,0.00,88.70,5361.50,pulp cap - direct (excluding final restoration) +D3120,0.00,33.11,1248.18,pulp cap - indirect (excluding final restoration) +D3125,0.00,0.00,0.00,pulp cap - unknown +D3140,0.00,0.00,0.00,pulp cap - unknown +D3160,0.00,84.50,169.00,pulp cap - unknown +D3170,0.00,0.00,0.00,pulp cap - unknown +D3179,0.00,0.00,0.00,pulp cap - unknown +D3199,0.00,0.00,0.00,pulp cap - unknown +D3200,0.00,162.50,325.00,pulpal procedure - unknown +D3210,0.00,0.00,0.00,pulpal procedure - unknown +D3211,13211.89,13211.89,13211.89,pulpal procedure - unknown +D3220,0.00,159.65,5808.00,therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction and application of medicament +D3221,0.00,236.74,9504.00,pulpal debridement primary and permanent teeth +D3222,0.00,0.00,0.00,partial pulpotomy for apexogenesis - permanent tooth with incomplete root development +D3223,250.00,250.00,250.00,pulpal procedure - unknown +D3224,0.00,0.00,0.00,pulpal procedure - unknown +D3226,0.00,0.00,0.00,pulpal procedure - unknown +D3229,0.00,0.00,0.00,pulpal procedure - unknown +D3230,0.00,16.21,891.60,pulpal therapy (resorbable filling) - anterior primary tooth (excluding final restoration) +D3240,0.00,46.42,382.00,pulpal therapy (resorbable filling) - posterior primary tooth (excluding final restoration) +D3241,0.00,337.50,450.00,pulpal procedure - unknown +D3242,0.00,0.00,0.00,pulpal procedure - unknown +D3244,0.00,0.00,0.00,pulpal procedure - unknown +D3246,0.00,0.00,0.00,pulpal procedure - unknown +D3255,0.00,0.00,0.00,pulpal procedure - unknown +D3258,0.00,0.00,0.00,pulpal procedure - unknown +D3260,0.00,0.00,0.00,pulpal procedure - unknown +D3273,859.00,859.00,859.00,pulpal procedure - unknown +D3292,0.00,0.00,0.00,pulpal procedure - unknown +D3299,0.00,0.00,0.00,pulpal procedure - unknown +D3300,0.00,0.00,0.00,endodontic procedure - unknown +D3301,0.00,0.00,0.00,endodontic procedure - unknown +D3303,0.00,0.00,0.00,endodontic procedure - unknown +D3307,0.00,0.00,0.00,endodontic procedure - unknown +D3308,0.00,0.00,0.00,endodontic procedure - unknown +D3310,0.00,54.92,20779.56,endodontic therapy anterior tooth (excluding final restoration) +D3311,0.00,0.00,0.00,endodontic procedure - unknown +D3312,0.00,0.00,0.00,endodontic procedure - unknown +D3314,0.00,0.00,0.00,endodontic procedure - unknown +D3315,0.00,0.00,0.00,endodontic procedure - unknown +D3318,0.00,0.00,0.00,endodontic procedure - unknown +D3320,0.00,77.26,22248.00,endodontic therapy premolar tooth (excluding final restoration) +D3325,358.30,358.30,358.30,endodontic procedure - unknown +D3330,0.00,52.95,5602.00,endodontic therapy molar tooth (excluding final restoration) +D3331,0.00,237.58,31255.00,treatment of root canal obstruction; non-surgical access +D3332,0.00,16.99,691.26,incomplete endodontic therapy; inoperable unrestorable or fractured tooth +D3333,0.00,0.00,0.00,internal root repair of perforation defects +D3339,0.00,915.00,1950.00,endodontic procedure - unknown +D3340,0.00,0.00,0.00,endodontic procedure - unknown +D3342,0.00,0.00,0.00,endodontic procedure - unknown +D3346,0.00,20.24,1376.25,retreatment of previous root canal therapy - anterior +D3347,0.00,43.10,1680.00,retreatment of previous root canal therapy - premolar +D3348,0.00,16.57,1550.00,retreatment of previous root canal therapy - molar +D3350,0.00,0.00,0.00,endodontic procedure - unknown +D3351,0.00,0.00,0.00,apexification/recalcification - initial visit (apical closure/calcific repair of perforations root resorption etc.) +D3352,0.00,0.00,0.00,apexification/recalcification - interim medication replacement +D3353,0.00,204.29,1430.00,apexification/recalcification - final visit (includes completed root canal therapy - apical closure/calcific repair of perforations root resorption etc.) +D3356,0.00,0.00,0.00,pulpal regeneration - interim medication replacement +D3370,0.00,0.00,0.00,endodontic procedure - unknown +D3373,0.00,0.00,0.00,endodontic procedure - unknown +D3380,0.00,0.00,0.00,endodontic procedure - unknown +D3382,0.00,0.00,0.00,endodontic procedure - unknown +D3384,0.00,0.00,0.00,endodontic procedure - unknown +D3389,0.00,0.00,0.00,endodontic procedure - unknown +D3390,0.00,0.00,0.00,endodontic procedure - unknown +D3392,0.00,0.00,0.00,endodontic procedure - unknown +D3402,0.00,0.00,0.00,endodontic procedure - unknown +D3408,0.00,5.00,20.00,endodontic procedure - unknown +D3410,0.00,36.43,5755.50,apicoectomy - anterior +D3411,0.00,0.00,0.00,endodontic procedure - unknown +D3420,0.00,0.00,0.00,endodontic procedure - unknown +D3421,0.00,17.43,5817.66,apicoectomy - premolar (first root) +D3422,0.00,0.00,0.00,endodontic procedure - unknown +D3425,0.00,8.90,2904.00,apicoectomy - molar (first root) +D3426,0.00,0.00,1.00,apicoectomy (each additional root) +D3427,0.00,0.00,0.00,endodontic procedure - unknown +D3428,0.00,0.00,0.00,bone graft in conjunction with periradicular surgery - per tooth single site +D3429,0.00,0.00,0.00,bone graft in conjunction with periradicular surgery - each additional contiguous tooth in the same surgical site +D3430,0.00,2.74,2488.18,retrograde filling - per root +D3431,0.00,84.95,3313.10,biologic materials to aid in soft and osseous tissue regeneration in conjunction with periradicular surgery +D3432,0.00,0.00,0.00,guided tissue regeneration resorbable barrier per site in conjunction with periradicular surgery +D3433,0.00,0.00,0.00,endodontic procedure - unknown +D3434,0.00,0.00,0.00,endodontic procedure - unknown +D3435,0.00,0.00,0.00,endodontic procedure - unknown +D3440,0.00,0.00,0.00,endodontic procedure - unknown +D3441,0.00,0.00,0.00,endodontic procedure - unknown +D3450,0.00,0.00,0.00,root amputation - per root +D3460,0.00,1480.78,7330.00,endodontic endosseous implant +D3470,0.00,0.00,0.00,intentional re-implantation (including necessary splinting) +D3472,0.00,0.00,0.00,surgical repair of root resorption - premolar +D3473,0.00,0.00,0.00,surgical repair of root resorption - molar +D3485,0.00,0.00,0.00,endodontic procedure - unknown +D3489,1732.21,1732.21,1732.21,endodontic procedure - unknown +D3490,0.00,1.40,35.00,endodontic procedure - unknown +D3499,0.00,0.00,0.00,endodontic procedure - unknown +D3500,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3501,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - anterior +D3510,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3516,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3525,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3526,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3530,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3533,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3560,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3562,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3587,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3590,0.00,0.00,0.00,surgical exposure of root surface without apicoectomy or repair of root resorption - unknown +D3610,0.00,0.00,0.00,endodontics procedure - unknown +D3615,0.00,68.10,136.20,endodontics procedure - unknown +D3620,723.14,723.14,723.14,endodontics procedure - unknown +D3641,0.00,0.00,0.00,endodontics procedure - unknown +D3642,1447.00,1447.00,1447.00,endodontics procedure - unknown +D3659,0.00,0.00,0.00,endodontics procedure - unknown +D3661,0.00,0.00,0.00,endodontics procedure - unknown +D3711,0.00,0.00,0.00,endodontics procedure - unknown +D3718,0.00,0.00,0.00,endodontics procedure - unknown +D3721,0.00,0.00,0.00,endodontics procedure - unknown +D3730,0.00,50.00,400.00,endodontics procedure - unknown +D3731,0.00,0.00,0.00,endodontics procedure - unknown +D3732,0.00,0.00,0.00,endodontics procedure - unknown +D3733,0.00,0.00,0.00,endodontics procedure - unknown +D3734,0.00,0.00,0.00,endodontics procedure - unknown +D3735,0.00,24.25,97.00,endodontics procedure - unknown +D3739,0.00,0.00,0.00,endodontics procedure - unknown +D3798,525.00,525.00,525.00,endodontics procedure - unknown +D3799,0.00,49.25,197.00,endodontics procedure - unknown +D3810,0.00,0.00,0.00,endodontics procedure - unknown +D3825,47.00,47.00,47.00,endodontics procedure - unknown +D3830,0.00,0.00,0.00,endodontics procedure - unknown +D3880,0.00,0.00,0.00,endodontics procedure - unknown +D3901,0.00,0.00,0.00,unspecified endodontic procedure - unknown +D3902,0.00,7394.17,14145.00,unspecified endodontic procedure - unknown +D3910,0.00,0.00,0.00,surgical procedure for isolation of tooth with rubber dam +D3911,0.00,0.00,0.00,intraorifice barrier +D3920,0.00,0.00,0.00,hemisection (including any root removal) not including root canal therapy +D3930,0.00,0.00,0.00,unspecified endodontic procedure - unknown +D3940,0.00,0.00,0.00,unspecified endodontic procedure - unknown +D3950,0.00,0.00,0.00,canal preparation and fitting of preformed dowel or post +D3960,0.00,0.00,0.00,unspecified endodontic procedure - unknown +D3961,0.00,11.50,69.00,unspecified endodontic procedure - unknown +D3962,0.00,0.00,0.00,unspecified endodontic procedure - unknown +D3963,0.00,50.00,100.00,unspecified endodontic procedure - unknown +D3965,0.00,0.00,0.00,unspecified endodontic procedure - unknown +D3970,40.00,40.00,40.00,unspecified endodontic procedure - unknown +D3971,0.00,0.00,0.00,unspecified endodontic procedure - unknown +D3981,31900.00,31900.00,31900.00,unspecified endodontic procedure - unknown +D3992,0.00,0.00,0.00,unspecified endodontic procedure - unknown +D3999,0.00,371.91,4245.81,unspecified endodontic procedure by report +D4000,0.00,2.00,30.00,endodontics procedure - unknown +D4001,0.00,0.00,0.00,periodontics procedure - unknown +D4002,0.00,0.00,0.00,periodontics procedure - unknown +D4003,0.00,0.00,0.00,periodontics procedure - unknown +D4005,0.00,0.00,0.00,periodontics procedure - unknown +D4006,0.00,0.00,0.00,periodontics procedure - unknown +D4010,0.00,0.00,0.00,periodontics procedure - unknown +D4011,0.00,0.00,0.00,periodontics procedure - unknown +D4013,0.00,0.00,0.00,periodontics procedure - unknown +D4018,0.00,75.00,225.00,periodontics procedure - unknown +D4020,0.00,0.00,0.00,periodontics procedure - unknown +D4021,0.00,0.00,0.00,periodontics procedure - unknown +D4022,0.00,0.00,0.00,periodontics procedure - unknown +D4023,0.00,0.00,0.00,periodontics procedure - unknown +D4024,0.00,0.00,0.00,periodontics procedure - unknown +D4025,0.00,0.00,0.00,periodontics procedure - unknown +D4026,0.00,0.00,0.00,periodontics procedure - unknown +D4028,0.00,0.00,0.00,periodontics procedure - unknown +D4034,0.00,19.60,39.20,periodontics procedure - unknown +D4035,0.00,0.00,0.00,periodontics procedure - unknown +D4037,0.00,0.00,0.00,periodontics procedure - unknown +D4038,0.00,0.00,0.00,periodontics procedure - unknown +D4046,0.00,0.00,0.00,periodontics procedure - unknown +D4048,0.00,0.00,0.00,periodontics procedure - unknown +D4049,0.00,0.00,0.00,periodontics procedure - unknown +D4050,0.00,0.00,0.00,periodontics procedure - unknown +D4051,0.00,0.00,0.00,periodontics procedure - unknown +D4052,0.00,0.00,0.00,periodontics procedure - unknown +D4055,0.00,0.00,0.00,periodontics procedure - unknown +D4060,0.00,0.00,0.00,periodontics procedure - unknown +D4061,0.00,0.00,0.00,periodontics procedure - unknown +D4062,0.00,0.00,0.00,periodontics procedure - unknown +D4070,0.00,0.00,0.00,periodontics procedure - unknown +D4080,0.00,32.86,460.00,periodontics procedure - unknown +D4081,0.00,27.56,200.00,periodontics procedure - unknown +D4082,0.00,0.00,0.00,periodontics procedure - unknown +D4086,0.00,0.00,0.00,periodontics procedure - unknown +D4087,0.00,0.00,0.00,periodontics procedure - unknown +D4100,0.00,12.87,127.96,periodontics procedure - unknown +D4101,0.00,0.00,0.00,periodontics procedure - unknown +D4102,0.00,10.87,21.60,periodontics procedure - unknown +D4103,0.00,0.00,0.00,periodontics procedure - unknown +D4104,0.00,0.00,0.00,periodontics procedure - unknown +D4110,0.00,1.62,30.00,periodontics procedure - unknown +D4111,0.00,0.00,0.00,periodontics procedure - unknown +D4112,0.00,0.00,0.00,periodontics procedure - unknown +D4120,0.00,0.00,0.00,periodontics procedure - unknown +D4132,0.00,7.00,14.00,periodontics procedure - unknown +D4140,0.00,0.00,0.00,periodontics procedure - unknown +D4150,0.00,0.00,0.00,periodontics procedure - unknown +D4152,0.00,6.55,65.52,periodontics procedure - unknown +D4154,0.00,0.00,0.00,periodontics procedure - unknown +D4155,118.50,118.50,118.50,periodontics procedure - unknown +D4162,0.00,0.00,0.00,periodontics procedure - unknown +D4165,124.00,124.00,124.00,periodontics procedure - unknown +D4166,187.50,187.50,187.50,periodontics procedure - unknown +D4172,0.00,0.00,0.00,periodontics procedure - unknown +D4176,3886.00,3886.00,3886.00,periodontics procedure - unknown +D4182,0.00,0.00,0.00,periodontics procedure - unknown +D4185,0.00,0.00,0.00,periodontics procedure - unknown +D4187,0.00,0.00,0.00,periodontics procedure - unknown +D4189,0.00,266.67,400.00,periodontics procedure - unknown +D4193,0.00,0.00,0.00,periodontics procedure - unknown +D4199,133.33,266.67,400.00,periodontics procedure - unknown +D4200,0.00,0.00,0.00,tissue procedure - unknown +D4203,0.00,0.00,0.00,tissue procedure - unknown +D4205,0.00,0.00,0.00,tissue procedure - unknown +D4209,0.00,0.00,0.00,tissue procedure - unknown +D4210,0.00,208.22,9887.50,gingivectomy or gingivoplasty - four or more contiguous teeth or tooth bounded spaces per quadrant +D4211,0.00,155.67,9504.00,gingivectomy or gingivoplasty - one to three contiguous teeth or tooth bounded spaces per quadrant +D4212,0.00,72.04,4523.33,gingivectomy or gingivoplasty to allow access for restorative procedure per tooth +D4215,0.00,0.00,0.00,tissue procedure - unknown +D4220,0.00,0.00,0.00,tissue procedure - unknown +D4221,0.00,0.00,0.00,tissue procedure - unknown +D4226,0.00,0.00,0.00,tissue procedure - unknown +D4227,0.00,0.00,0.00,tissue procedure - unknown +D4230,0.00,1696.85,5090.55,anatomical crown exposure - four or more contiguous teeth or tooth bounded spaces per quadrant +D4231,0.00,0.00,0.00,anatomical crown exposure - one to three teeth or tooth bounded spaces per quadrant +D4237,0.00,0.00,0.00,tissue procedure - unknown +D4239,0.00,0.00,0.00,tissue procedure - unknown +D4240,0.00,54.64,4318.80,gingival flap procedure including root planing - four or more contiguous teeth or tooth bounded spaces per quadrant +D4241,0.00,18.96,936.00,gingival flap procedure including root planing - one to three contiguous teeth or tooth bounded spaces per quadrant +D4242,0.00,0.00,0.00,tissue procedure - unknown +D4245,0.00,0.02,1.00,apically positioned flap +D4248,0.00,0.00,0.00,tissue procedure - unknown +D4249,0.00,15.12,1122.00,clinical crown lengthening - hard tissue +D4250,0.00,0.00,0.00,tissue procedure - unknown +D4251,0.00,0.00,0.00,tissue procedure - unknown +D4252,0.00,0.00,0.00,tissue procedure - unknown +D4253,0.00,0.00,0.00,tissue procedure - unknown +D4254,0.00,0.00,0.00,tissue procedure - unknown +D4256,0.00,0.00,0.00,tissue procedure - unknown +D4257,0.00,0.00,0.00,tissue procedure - unknown +D4258,0.00,0.00,0.00,tissue procedure - unknown +D4259,0.00,0.00,0.00,tissue procedure - unknown +D4260,0.00,129.17,10414.50,osseous surgery (including elevation of a full thickness flap and closure) - four or more contiguous teeth or tooth bounded spaces per quadrant +D4261,0.00,10.77,1685.00,osseous surgery (including elevation of a full thickness flap and closure) - one to three contiguous teeth or tooth bounded spaces per quadrant +D4262,0.00,0.00,0.00,tissue procedure - unknown +D4263,0.00,25.86,3604.36,bone replacement graft - retained natural tooth - first site in quadrant +D4264,0.00,70.52,2878.00,bone replacement graft - retained natural tooth - each additional site in quadrant +D4265,0.00,6.42,4394.66,biologic materials to aid in soft and osseous tissue regeneration per site +D4266,0.00,25.33,10311.00,guided tissue regeneration natural teeth - resorbable barrier per site +D4267,0.00,2.72,1297.85,guided tissue regeneration natural teeth - non-resorbable barrier per site +D4268,0.00,90.43,1457.00,surgical revision procedure per tooth +D4269,0.00,0.00,0.00,tissue procedure - unknown +D4270,0.00,104.36,4245.81,pedicle soft tissue graft procedure +D4271,0.00,40.00,8278.00,tissue procedure - unknown +D4273,0.00,54.16,8783.00,autogenous connective tissue graft procedure (including donor and recipient surgical sites) first tooth implant or edentulous tooth position in graft +D4274,0.00,0.06,1.00,mesial/distal wedge procedure single tooth (when not performed in conjunction with surgical procedures in the same anatomical area) +D4275,0.00,6.49,1585.29,non-autogenous connective tissue graft (including recipient site and donor material) first tooth implant or edentulous tooth position in graft +D4276,0.00,0.00,0.00,combined connective tissue and pedicle graft per tooth +D4277,0.00,0.87,412.43,free soft tissue graft procedure (including recipient and donor surgical sites) first tooth implant or edentulous tooth position in graft +D4278,0.00,0.00,0.00,free soft tissue graft procedure (including recipient and donor surgical sites) each additional contiguous tooth implant or edentulous tooth position in same graft site +D4280,0.00,0.00,0.00,tissue procedure - unknown +D4281,0.00,0.00,0.00,tissue procedure - unknown +D4283,0.00,7.33,462.05,autogenous connective tissue graft procedure (including donor and recipient surgical sites) - each additional contiguous tooth implant or edentulous tooth position in same graft site +D4285,0.00,0.00,0.00,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 +D4286,0.00,13.89,250.00,removal of non-resorbable barrier +D4287,0.00,0.00,0.00,tissue procedure - unknown +D4289,0.00,0.00,0.00,tissue procedure - unknown +D4291,0.00,0.00,0.00,tissue procedure - unknown +D4292,0.00,0.00,0.00,tissue procedure - unknown +D4293,0.00,0.00,0.00,tissue procedure - unknown +D4295,0.00,0.00,0.00,tissue procedure - unknown +D4299,0.00,0.00,0.00,tissue procedure - unknown +D4300,0.00,0.00,0.00,periodontic procedure - unknown +D4310,0.00,17.14,30.00,periodontic procedure - unknown +D4314,0.00,0.00,0.00,periodontic procedure - unknown +D4320,0.00,1.61,123.00,periodontic procedure - unknown +D4321,0.00,15.10,736.00,periodontic procedure - unknown +D4322,0.00,46.88,187.50,splint - intra-coronal; natural teeth or prosthetic crowns +D4323,0.00,176.89,1080.00,splint - extra-coronal; natural teeth or prosthetic crowns +D4324,0.00,0.00,0.00,periodontic procedure - unknown +D4325,0.00,0.00,0.00,periodontic procedure - unknown +D4326,0.00,0.00,0.00,periodontic procedure - unknown +D4327,0.00,0.00,0.00,periodontic procedure - unknown +D4330,0.00,0.00,0.00,periodontic procedure - unknown +D4331,0.00,0.00,0.00,periodontic procedure - unknown +D4332,0.00,0.00,0.00,periodontic procedure - unknown +D4333,0.00,0.00,0.00,periodontic procedure - unknown +D4335,0.00,0.00,0.00,periodontic procedure - unknown +D4337,0.00,0.00,0.00,periodontic procedure - unknown +D4338,0.00,0.00,0.00,periodontic procedure - unknown +D4340,0.00,0.00,0.00,periodontic procedure - unknown +D4341,0.00,156.56,76205.00,periodontal scaling and root planing - four or more teeth per quadrant +D4342,0.00,126.04,10598.25,periodontal scaling and root planing - one to three teeth per quadrant +D4344,0.00,0.00,0.00,periodontic procedure - unknown +D4345,0.00,0.00,0.00,periodontic procedure - unknown +D4346,0.00,1110.66,24191.00,scaling in presence of generalized moderate or severe gingival inflammation - full mouth after oral evaluation +D4347,0.00,0.00,0.00,periodontic procedure - unknown +D4349,0.00,0.00,0.00,periodontic procedure - unknown +D4350,0.00,0.00,0.00,periodontic procedure - unknown +D4355,0.00,735.12,24255.00,full mouth debridement to enable a comprehensive periodontal evaluation and diagnosis on a subsequent visit +D4359,0.00,0.00,0.00,periodontic procedure - unknown +D4360,0.00,0.00,0.00,periodontic procedure - unknown +D4361,0.00,0.00,0.00,periodontic procedure - unknown +D4362,0.00,0.00,0.00,periodontic procedure - unknown +D4364,0.00,31.00,62.00,periodontic procedure - unknown +D4365,0.00,0.00,0.00,periodontic procedure - unknown +D4367,0.00,0.00,0.00,periodontic procedure - unknown +D4371,0.00,267.47,300.90,periodontic procedure - unknown +D4376,0.00,0.00,0.00,periodontic procedure - unknown +D4380,0.00,0.00,0.00,periodontic procedure - unknown +D4381,0.00,2.68,2718.54,localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue per tooth +D4382,0.00,0.00,0.00,periodontic procedure - unknown +D4396,0.00,0.00,0.00,periodontic procedure - unknown +D4397,0.00,0.00,0.00,periodontic procedure - unknown +D4399,0.00,0.00,0.00,periodontic procedure - unknown +D4400,0.00,25.00,50.00,periodontics procedure - unknown +D4403,0.00,0.00,0.00,periodontics procedure - unknown +D4404,0.00,0.00,0.00,periodontics procedure - unknown +D4407,0.00,0.00,0.00,periodontics procedure - unknown +D4414,0.00,0.00,0.00,periodontics procedure - unknown +D4419,0.00,0.00,0.00,periodontics procedure - unknown +D4438,0.00,0.00,0.00,periodontics procedure - unknown +D4439,25.45,25.45,25.45,periodontics procedure - unknown +D4443,0.00,28.70,114.81,periodontics procedure - unknown +D4449,0.00,0.00,0.00,periodontics procedure - unknown +D4450,0.00,0.00,0.00,periodontics procedure - unknown +D4455,0.00,0.00,0.00,periodontics procedure - unknown +D4460,0.00,0.00,0.00,periodontics procedure - unknown +D4478,77.87,77.87,77.87,periodontics procedure - unknown +D4480,0.00,0.00,0.00,periodontics procedure - unknown +D4481,0.00,0.00,0.00,periodontics procedure - unknown +D4482,0.00,0.00,0.00,periodontics procedure - unknown +D4484,0.00,0.00,0.00,periodontics procedure - unknown +D4486,0.00,0.00,0.00,periodontics procedure - unknown +D4489,0.00,0.00,0.00,periodontics procedure - unknown +D4499,0.00,0.00,0.00,periodontics procedure - unknown +D4500,0.00,0.00,0.00,periodontics procedure - unknown +D4502,0.00,0.00,0.00,periodontics procedure - unknown +D4520,0.00,0.00,0.00,periodontics procedure - unknown +D4525,0.00,0.00,0.00,periodontics procedure - unknown +D4533,0.00,108.13,216.25,periodontics procedure - unknown +D4550,0.00,0.00,0.00,periodontics procedure - unknown +D4580,0.00,72.00,180.00,periodontics procedure - unknown +D4596,0.00,0.00,0.00,periodontics procedure - unknown +D4609,0.00,0.00,0.00,periodontics procedure - unknown +D4610,0.00,0.00,0.00,periodontics procedure - unknown +D4612,0.00,0.00,0.00,periodontics procedure - unknown +D4621,0.00,0.00,0.00,periodontics procedure - unknown +D4625,0.00,0.00,0.00,periodontics procedure - unknown +D4626,0.00,0.00,0.00,periodontics procedure - unknown +D4640,0.00,0.00,0.00,periodontics procedure - unknown +D4641,0.00,0.00,0.00,periodontics procedure - unknown +D4648,0.00,0.00,0.00,periodontics procedure - unknown +D4649,0.00,0.00,0.00,periodontics procedure - unknown +D4653,0.00,0.00,0.00,periodontics procedure - unknown +D4657,8.39,8.39,8.39,periodontics procedure - unknown +D4685,0.00,0.00,0.00,periodontics procedure - unknown +D4700,0.00,0.00,0.00,periodontics procedure - unknown +D4710,0.00,0.00,0.00,periodontics procedure - unknown +D4711,0.00,0.00,0.00,periodontics procedure - unknown +D4721,0.00,0.00,0.00,periodontics procedure - unknown +D4725,0.00,375.00,750.00,periodontics procedure - unknown +D4726,0.00,0.00,0.00,periodontics procedure - unknown +D4735,0.00,0.00,0.00,periodontics procedure - unknown +D4739,0.00,0.00,0.00,periodontics procedure - unknown +D4760,0.00,0.00,0.00,periodontics procedure - unknown +D4803,0.00,0.00,0.00,periodontics procedure - unknown +D4808,0.00,0.00,0.00,periodontics procedure - unknown +D4815,0.00,0.00,0.00,periodontics procedure - unknown +D4859,0.00,0.00,0.00,periodontics procedure - unknown +D4860,0.00,0.00,0.00,periodontics procedure - unknown +D4882,0.00,0.00,0.00,periodontics procedure - unknown +D4900,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4904,0.00,60.00,120.00,unspecified periodontal procedure - unknown +D4908,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4910,0.00,3.91,5216.64,periodontal maintenance +D4911,0.00,70.00,175.00,unspecified periodontal procedure - unknown +D4912,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4915,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4920,0.00,0.10,42.50,unscheduled dressing change (by someone other than treating dentist or their staff) +D4921,0.00,0.22,22.00,gingival irrigation with a medicinal agent - per quadrant +D4922,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4931,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4936,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4940,0.00,11.11,50.00,unspecified periodontal procedure - unknown +D4950,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4968,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4990,0.00,16.25,65.00,unspecified periodontal procedure - unknown +D4991,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4994,0.00,160.00,400.00,unspecified periodontal procedure - unknown +D4997,0.00,10.89,32.50,unspecified periodontal procedure - unknown +D4998,0.00,0.00,0.00,unspecified periodontal procedure - unknown +D4999,0.00,13.75,2644.50,unspecified periodontal procedure by report +D5000,0.00,0.95,21.00,periodontics procedure - unknown +D5001,0.00,22.83,189.48,prosthodontics - removable procedure - unknown +D5002,0.00,49.13,229.40,prosthodontics - removable procedure - unknown +D5003,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5004,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5005,0.00,127.28,636.38,prosthodontics - removable procedure - unknown +D5006,600.00,600.00,600.00,prosthodontics - removable procedure - unknown +D5007,500.00,500.00,500.00,prosthodontics - removable procedure - unknown +D5010,0.00,461.54,2400.00,prosthodontics - removable procedure - unknown +D5011,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5018,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5022,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5025,0.00,46.95,190.67,prosthodontics - removable procedure - unknown +D5030,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5040,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5041,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5043,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5045,0.00,30.00,75.00,prosthodontics - removable procedure - unknown +D5049,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5055,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5056,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5057,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5060,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5061,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5063,3.00,3.00,3.00,prosthodontics - removable procedure - unknown +D5080,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5088,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5100,0.00,0.00,0.00,denture - unknown +D5101,0.00,0.00,0.00,denture - unknown +D5102,0.00,0.00,0.00,denture - unknown +D5103,0.00,0.00,0.00,denture - unknown +D5104,0.00,0.00,0.00,denture - unknown +D5107,0.00,0.00,0.00,denture - unknown +D5108,0.00,0.00,0.00,denture - unknown +D5109,0.00,0.00,0.00,denture - unknown +D5110,0.00,88.98,5027.90,complete denture - maxillary +D5111,0.00,0.00,0.00,denture - unknown +D5112,0.00,419.40,629.10,denture - unknown +D5115,0.00,438.65,1652.00,denture - unknown +D5117,0.00,0.00,0.00,denture - unknown +D5118,0.00,0.00,0.00,denture - unknown +D5120,0.00,81.52,4251.38,complete denture - mandibular +D5124,0.00,0.00,0.00,denture - unknown +D5125,0.00,0.00,0.00,denture - unknown +D5130,0.00,37.83,3216.00,immediate denture - maxillary +D5131,0.00,0.00,0.00,denture - unknown +D5132,0.00,313.37,1099.00,denture - unknown +D5134,0.00,0.00,0.00,denture - unknown +D5135,0.00,61.91,1981.00,denture - unknown +D5138,0.00,0.00,0.00,denture - unknown +D5139,0.00,0.00,0.00,denture - unknown +D5140,0.00,25.97,2649.78,immediate denture - mandibular +D5141,359.00,359.00,359.00,denture - unknown +D5142,0.00,180.67,1099.00,denture - unknown +D5144,0.00,0.00,0.00,denture - unknown +D5145,0.00,232.12,1981.00,denture - unknown +D5146,516.00,516.00,516.00,denture - unknown +D5147,516.00,516.00,516.00,denture - unknown +D5149,0.00,0.00,0.00,denture - unknown +D5150,0.00,0.00,0.00,denture - unknown +D5164,325.00,325.00,325.00,denture - unknown +D5165,25.00,25.00,25.00,denture - unknown +D5166,0.00,0.00,0.00,denture - unknown +D5190,0.00,0.00,0.00,denture - unknown +D5199,0.00,0.00,0.00,denture - unknown +D5200,0.00,47.80,478.00,denture - unknown +D5202,0.00,0.00,0.00,denture - unknown +D5203,0.00,0.00,0.00,denture - unknown +D5204,0.00,0.00,0.00,denture - unknown +D5210,0.00,0.00,0.00,denture - unknown +D5211,0.00,63.80,3568.00,maxillary partial denture - resin base (including retentive/clasping materials rests and teeth) +D5212,0.00,43.66,3925.00,mandibular partial denture - resin base (including retentive/clasping materials rests and teeth) +D5213,0.00,94.35,3568.00,maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials rests and teeth) +D5214,0.00,102.32,3925.00,mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials rests and teeth) +D5215,0.00,0.00,0.00,denture - unknown +D5220,0.00,0.00,0.00,denture - unknown +D5221,0.00,0.00,0.00,immediate maxillary partial denture - resin base (including retentive/clasping materials rests and teeth) +D5222,0.00,0.00,0.00,immediate mandibular partial denture - resin base (including retentive/clasping materials rests and teeth) +D5223,0.00,31.25,250.00,immediate maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials rests and teeth) +D5224,0.00,0.00,0.00,immediate mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials rests and teeth) +D5225,0.00,148.01,2632.77,maxillary partial denture - flexible base (including retentive/clasping materials rests and teeth) +D5226,0.00,65.36,2426.14,mandibular partial denture - flexible base (including retentive/clasping materials rests and teeth) +D5227,0.00,0.00,0.00,immediate maxillary partial denture - flexible base (including any clasps rests and teeth) +D5228,0.00,0.00,0.00,immediate mandibular partial denture - flexible base (including any clasps rests and teeth) +D5232,0.00,0.00,0.00,denture - unknown +D5241,0.00,0.00,0.00,denture - unknown +D5242,0.00,0.00,0.00,denture - unknown +D5254,0.00,0.00,0.00,denture - unknown +D5261,0.00,0.00,0.00,denture - unknown +D5262,0.00,0.00,0.00,denture - unknown +D5264,0.00,0.00,0.00,denture - unknown +D5266,0.00,0.00,0.00,denture - unknown +D5276,0.00,0.00,0.00,denture - unknown +D5280,0.00,270.83,675.00,denture - unknown +D5281,0.00,17.24,350.00,denture - unknown +D5282,0.00,0.00,0.00,removable unilateral partial denture - one piece cast metal (including retentive/clasping materials rests and teeth) maxillary +D5283,0.00,0.00,0.00,removable unilateral partial denture - one piece cast metal (including rententive/clasping materias rests and teeth) mandibular +D5290,0.00,0.00,0.00,denture - unknown +D5291,0.00,0.00,0.00,denture - unknown +D5293,0.00,0.00,0.00,denture - unknown +D5298,0.00,0.00,0.00,denture - unknown +D5299,0.00,0.00,0.00,denture - unknown +D5303,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5306,200.00,200.00,200.00,prosthodontics - removable procedure - unknown +D5310,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5335,49.00,49.00,49.00,prosthodontics - removable procedure - unknown +D5362,82.35,82.35,82.35,prosthodontics - removable procedure - unknown +D5379,43.00,43.00,43.00,prosthodontics - removable procedure - unknown +D5380,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5383,139.00,139.00,139.00,prosthodontics - removable procedure - unknown +D5385,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5396,0.00,0.00,0.00,prosthodontics - removable procedure - unknown +D5400,0.00,0.00,0.00,adjust denture - unknown +D5401,0.00,0.00,0.00,adjust denture - unknown +D5409,0.00,0.00,0.00,adjust denture - unknown +D5410,0.00,30.33,360.00,adjust complete denture - maxillary +D5411,0.00,13.04,367.00,adjust complete denture - mandibular +D5414,0.00,0.00,0.00,adjust denture - unknown +D5421,0.00,9.88,255.00,adjust partial denture - maxillary +D5422,0.00,12.22,360.00,adjust partial denture - mandibular +D5424,0.00,0.00,0.00,adjust denture - unknown +D5425,0.00,0.00,0.00,adjust denture - unknown +D5426,0.00,0.00,0.00,adjust denture - unknown +D5473,0.00,0.00,0.00,adjust denture - unknown +D5490,0.00,0.00,0.00,adjust denture - unknown +D5497,0.00,0.00,0.00,adjust denture - unknown +D5500,0.00,0.00,0.00,repair denture - unknown +D5510,0.00,17.66,375.00,repair denture - unknown +D5511,0.00,29.69,375.00,repair broken complete denture base mandibular +D5512,0.00,23.15,246.75,repair broken complete denture base maxillary +D5515,0.00,0.00,0.00,repair denture - unknown +D5520,0.00,9.93,718.00,replace missing or broken teeth - complete denture (each tooth) +D5559,0.00,0.00,0.00,repair denture - unknown +D5591,0.00,0.00,0.00,repair denture - unknown +D5600,0.00,0.00,0.00,repair denture - unknown +D5606,0.00,0.00,0.00,repair denture - unknown +D5610,0.00,11.53,327.00,repair denture - unknown +D5611,0.00,41.80,257.00,repair resin partial denture base mandibular +D5612,0.00,35.96,205.00,repair resin partial denture base maxillary +D5620,0.00,8.59,210.48,repair denture - unknown +D5621,0.00,44.10,308.70,repair cast partial framework mandibular +D5622,0.00,0.00,0.00,repair cast partial framework maxillary +D5630,0.00,18.67,400.00,repair or replace broken retentive clasping materials - per tooth +D5640,0.00,20.65,410.64,replace broken teeth - per tooth +D5650,0.00,11.62,431.00,add tooth to existing partial denture +D5652,31.89,31.89,31.89,repair denture - unknown +D5660,0.00,32.25,2906.50,add clasp to existing partial denture - per tooth +D5668,0.00,0.00,0.00,repair denture - unknown +D5670,0.00,4.55,300.00,replace all teeth and acrylic on cast metal framework (maxillary) +D5671,0.00,0.00,0.00,replace all teeth and acrylic on cast metal framework (mandibular) +D5682,0.00,0.00,0.00,repair denture - unknown +D5698,0.00,0.00,0.00,repair denture - unknown +D5709,0.00,136.00,272.00,rebase or reline denture - unknown +D5710,0.00,0.02,1.00,rebase complete maxillary denture +D5711,0.00,34.87,638.89,rebase complete mandibular denture +D5720,0.00,0.00,0.00,rebase maxillary partial denture +D5721,0.00,0.00,0.00,rebase mandibular partial denture +D5725,0.00,0.00,0.00,rebase hybrid prosthesis +D5726,0.00,0.00,0.00,rebase or reline denture - unknown +D5730,0.00,33.83,4698.75,reline complete maxillary denture (direct) +D5731,0.00,16.30,378.29,reline complete mandibular denture (direct) +D5740,0.00,28.72,550.00,reline maxillary partial denture (direct) +D5741,0.00,8.18,373.70,reline mandibular partial denture (direct) +D5750,0.00,17.21,696.00,reline complete maxillary denture (indirect) +D5751,0.00,15.25,696.00,reline complete mandibular denture (indirect) +D5753,0.00,0.00,0.00,rebase or reline denture - unknown +D5756,0.00,0.00,0.00,rebase or reline denture - unknown +D5760,0.00,22.85,623.23,reline maxillary partial denture (indirect) +D5761,0.00,47.80,626.71,reline mandibular partial denture (indirect) +D5786,0.00,0.00,0.00,rebase or reline denture - unknown +D5788,0.00,0.00,0.00,rebase or reline denture - unknown +D5798,0.00,1.83,5.95,rebase or reline denture - unknown +D5807,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5810,0.00,5.15,518.00,interim complete denture (maxillary) +D5811,0.00,8.19,795.00,interim complete denture (mandibular) +D5819,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5820,0.00,82.64,52000.00,interim partial denture (including retentive/clasping materials rests and teeth) maxillary +D5821,0.00,24.55,1118.00,interim partial denture (including retentive/clasping materials rests and teeth) mandibular +D5822,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5828,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5831,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5832,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5840,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5850,0.00,3.02,315.00,tissue conditioning maxillary +D5851,0.00,1.96,315.00,tissue conditioning mandibular +D5853,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5854,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5858,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5860,0.00,62.92,1400.00,unspecified removable prosthodontic procedure - unknown +D5861,0.00,113.47,1928.98,unspecified removable prosthodontic procedure - unknown +D5862,0.00,3.03,450.00,precision attachment by report +D5863,0.00,0.00,0.00,overdenture - complete maxillary +D5864,0.00,246.25,985.00,overdenture - partial maxillary +D5865,0.00,0.00,0.00,overdenture - complete mandibular +D5866,0.00,0.00,0.00,overdenture - partial mandibular +D5867,0.00,12.45,1095.90,replacement of replaceable part of semi-precision or precision attachment per attachment +D5868,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5875,0.00,23.06,582.39,modification of removable prosthesis following implant surgery +D5876,0.00,0.00,0.00,add metal substructure to acrylic full denture (per arch) +D5885,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5886,0.00,22.03,66.08,unspecified removable prosthodontic procedure - unknown +D5888,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5889,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5896,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5897,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5898,0.00,0.00,0.00,unspecified removable prosthodontic procedure - unknown +D5899,0.00,62.62,4370.00,unspecified removable prosthodontic procedure by report +D5900,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5910,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5911,0.00,20.00,70.00,facial moulage (sectional) +D5913,0.00,1039.63,5000.00,nasal prosthesis +D5914,0.00,753.33,2260.00,auricular prosthesis +D5915,0.00,0.00,0.00,orbital prosthesis +D5916,0.00,0.00,0.00,ocular prosthesis +D5919,0.00,0.00,0.00,facial prosthesis +D5922,0.00,25.73,975.00,nasal septal prosthesis +D5923,0.00,833.33,5000.00,ocular prosthesis interim +D5924,0.00,0.00,0.00,cranial prosthesis +D5925,0.00,132.67,398.00,facial augmentation implant prosthesis +D5927,0.00,0.00,0.00,auricular prosthesis replacement +D5928,0.00,0.00,0.00,orbital prosthesis replacement +D5929,0.00,0.00,0.00,facial prosthesis replacement +D5930,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5931,0.00,259.98,14300.00,obturator prosthesis surgical +D5932,0.00,123.60,10318.00,obturator prosthesis definitive +D5933,0.00,8.22,440.00,obturator prosthesis modification +D5934,0.00,0.00,0.00,mandibular resection prosthesis with guide flange +D5935,0.00,0.00,0.00,mandibular resection prosthesis without guide flange +D5936,0.00,137.92,6885.00,obturator prosthesis interim +D5937,0.00,0.00,0.00,trismus appliance (not for TMD treatment) +D5951,0.00,8.11,55.00,feeding aid +D5952,0.00,0.00,0.00,speech aid prosthesis pediatric +D5953,0.00,0.00,0.00,speech aid prosthesis adult +D5954,0.00,970.69,4019.00,palatal augmentation prosthesis +D5955,0.00,0.00,0.00,palatal lift prosthesis definitive +D5956,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5958,0.00,0.00,0.00,palatal lift prosthesis interim +D5959,0.00,0.00,0.00,palatal lift prosthesis modification +D5960,0.00,0.00,0.00,speech aid prosthesis modification +D5975,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5978,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5981,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5982,0.00,9.08,1998.00,surgical stent +D5983,0.00,0.00,0.00,radiation carrier +D5984,0.00,21.46,1251.06,radiation shield +D5985,0.00,49.28,1500.00,radiation cone locator +D5986,0.00,1.83,525.00,fluoride gel carrier +D5987,0.00,0.00,0.00,commissure splint +D5988,0.00,20.10,950.00,surgical splint +D5989,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5991,0.00,11.48,389.00,vesiculobullous disease medicament carrier +D5992,0.00,0.00,0.00,adjust maxillofacial prosthetic appliance by report +D5993,0.00,0.00,0.00,maintenance and cleaning of a maxillofacial prosthesis (extra- or intra-oral) other than required adjustments by report +D5994,0.00,751.36,16530.00,unspecified maxillofacial prosthesis - unknown +D5995,0.00,0.00,0.00,periodontal medicament carrier with peripheral seal - laboratory processed - maxillary +D5996,0.00,0.00,0.00,periodontal medicament carrier with peripheral seal - laboratory processed - mandibular +D5997,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5998,0.00,0.00,0.00,unspecified maxillofacial prosthesis - unknown +D5999,0.00,139.33,2800.00,unspecified maxillofacial prosthesis by report +D6000,0.00,0.00,0.00,implant - unknown +D6001,0.00,0.00,0.00,implant - unknown +D6002,0.00,0.00,0.00,implant - unknown +D6003,0.00,0.00,0.00,implant - unknown +D6004,0.00,0.00,0.00,implant - unknown +D6005,0.00,0.00,0.00,implant - unknown +D6009,0.00,22.11,398.00,implant - unknown +D6010,0.00,110.62,38012.00,surgical placement of implant body: endosteal implant +D6011,0.00,36.83,19617.00,surgical access to an implant body (second stage implant surgery) +D6012,0.00,5.49,607.00,surgical placement of interim implant body for transitional prosthesis: endosteal implant +D6013,0.00,73.63,4200.00,surgical placement of mini implant +D6014,0.00,36.67,220.00,implant - unknown +D6015,0.00,0.00,0.00,implant - unknown +D6017,1600.00,1600.00,1600.00,implant - unknown +D6019,1900.00,1900.00,1900.00,implant - unknown +D6020,0.00,40.06,2200.00,implant - unknown +D6021,0.00,0.00,0.00,implant - unknown +D6024,0.00,604.00,1208.00,implant - unknown +D6025,0.00,0.00,0.00,implant - unknown +D6026,0.00,0.00,0.00,implant - unknown +D6027,0.00,0.00,0.00,implant - unknown +D6030,0.00,0.00,0.00,implant - unknown +D6031,0.00,0.00,0.00,implant - unknown +D6034,0.00,0.00,0.00,implant - unknown +D6040,0.00,325.47,6968.40,surgical placement: eposteal implant +D6042,0.00,0.00,0.00,implant - unknown +D6050,0.00,0.00,0.00,surgical placement: transosteal implant +D6051,0.00,43.90,11900.00,interim implant abutment placement +D6052,0.00,0.00,0.00,implant - unknown +D6053,0.00,109.28,10581.00,implant - unknown +D6054,0.00,229.17,3243.06,implant - unknown +D6055,0.00,142.50,7000.00,connecting bar - implant supported or abutment supported +D6056,0.00,95.14,6353.00,prefabricated abutment - includes modification and placement +D6057,0.00,11.01,1698.00,custom fabricated abutment - includes placement +D6058,0.00,16.77,1778.20,abutment supported porcelain/ceramic crown +D6059,0.00,26.99,2976.22,abutment supported porcelain fused to metal crown (high noble metal) +D6060,0.00,149.69,1280.00,abutment supported porcelain fused to metal crown (predominantly base metal) +D6061,0.00,36.30,1716.74,abutment supported porcelain fused to metal crown (noble metal) +D6062,0.00,96.33,1711.09,abutment supported cast metal crown (high noble metal) +D6063,0.00,0.00,0.00,abutment supported cast metal crown (predominantly base metal) +D6064,0.00,0.00,0.00,abutment supported cast metal crown (noble metal) +D6065,0.00,68.21,2889.00,implant supported porcelain/ceramic crown +D6066,0.00,43.21,2889.00,implant supported crown - porcelain fused to high noble alloys +D6067,0.00,90.40,1717.65,implant supported crown - high noble alloys +D6068,0.00,0.00,0.00,abutment supported retainer for porcelain/ceramic FPD +D6069,0.00,4.75,1530.00,abutment supported retainer for porcelain fused to metal FPD (high noble metal) +D6070,0.00,0.00,0.00,abutment supported retainer for porcelain fused to metal FPD (predominantly base metal) +D6071,0.00,0.00,0.00,abutment supported retainer for porcelain fused to metal FPD (noble metal) +D6072,0.00,0.00,0.00,abutment supported retainer for cast metal FPD (high noble metal) +D6074,0.00,0.00,0.00,abutment supported retainer for cast metal FPD (noble metal) +D6075,0.00,40.64,2330.86,implant supported retainer for ceramic FPD +D6076,0.00,0.00,0.00,implant supported retainer for FPD - porcelain fused to high noble alloys +D6077,0.00,0.00,0.00,implant supported retainer for metal FPD - high noble alloys +D6078,0.00,46.73,5000.00,implant - unknown +D6079,0.00,0.00,0.00,implant - unknown +D6080,0.00,19.91,2000.00,implant maintenance procedures when prostheses are removed and reinserted including cleansing of prostheses and abutments +D6081,0.00,0.00,0.00,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 +D6082,0.00,19.23,250.00,implant supported crown - porcelain fused to predominantly base alloys +D6083,0.00,0.00,0.00,implant supported crown - porcelain fused to noble alloys +D6085,0.00,0.00,0.00,interim implant crown +D6086,0.00,0.00,0.00,implant supported crown - predominantly base alloys +D6088,0.00,1155.07,2310.13,implant supported crown - titanium and titanium alloys +D6090,0.00,12.39,250.00,repair implant supported prosthesis by report +D6091,0.00,156.34,839.40,replacement of replaceable part of semi-precision or precision attachment of implant/abutment supported prosthesis per attachment +D6092,0.00,140.01,2798.50,re-cement or re-bond implant/abutment supported crown +D6093,0.00,44.64,244.44,re-cement or re-bond implant/abutment supported fixed partial denture +D6094,0.00,0.00,0.00,abutment supported crown - titanium and titanium alloys +D6095,0.00,7.14,250.00,repair implant abutment by report +D6096,0.00,0.00,0.00,remove broken implant retaining screw +D6099,0.00,0.00,0.00,implant supported retainer for FPD - porcelain fused to noble alloys +D6100,0.00,90.64,14576.00,surgical removal of implant body +D6101,0.00,15.56,2325.75,debridement of a peri-implant defect or defects surrounding a single implant and surface cleaning of the exposed implant surfaces including flap entry and closure +D6102,0.00,17.82,1532.50,debridement and osseous contouring of a peri-implant defect or defects surrounding a single implant and includes surface cleaning of the exposed implant surfaces including flap entry and closure +D6103,0.00,0.46,100.00,bone graft for repair of peri-implant defect - does not include flap entry and closure +D6104,0.00,15.40,4651.50,bone graft at time of implant placement +D6105,0.00,3334.29,7780.00,removal of implant body not requiring bone removal or flap elevation +D6106,0.00,0.00,0.00,guided tissue regeneration - resorbable barrier per implant +D6110,0.00,36.55,3984.00,implant /abutment supported removable denture for edentulous arch - maxillary +D6111,0.00,0.00,0.00,implant /abutment supported removable denture for edentulous arch - mandibular +D6112,0.00,0.00,0.00,implant /abutment supported removable denture for partially edentulous arch - maxillary +D6113,0.00,0.00,0.00,implant /abutment supported removable denture for partially edentulous arch - mandibular +D6114,0.00,146.17,6679.00,implant /abutment supported fixed denture for edentulous arch - maxillary +D6115,0.00,26.04,2943.72,implant /abutment supported fixed denture for edentulous arch - mandibular +D6116,0.00,2100.00,21000.00,implant /abutment supported fixed denture for partially edentulous arch - maxillary +D6117,0.00,395.46,9886.50,implant /abutment supported fixed denture for partially edentulous arch - mandibular +D6118,0.00,0.00,0.00,implant/abutment supported interim fixed denture for edentulous arch - mandibular +D6119,0.00,0.00,0.00,implant/abutment supported interim fixed denture for edentulous arch - maxillary +D6120,0.00,3.51,52.61,implant supported retainer - porcelain fused to titanium and titanium alloys +D6122,0.00,0.00,0.00,implant supported retainer for metal FPD - noble alloys +D6125,0.00,0.00,0.00,unspecified implant procedure - unknown +D6140,0.00,181.25,725.00,unspecified implant procedure - unknown +D6151,0.00,0.00,0.00,unspecified implant procedure - unknown +D6152,0.00,0.00,0.00,unspecified implant procedure - unknown +D6156,269.00,269.00,269.00,unspecified implant procedure - unknown +D6157,35.00,35.00,35.00,unspecified implant procedure - unknown +D6170,0.00,0.00,0.00,unspecified implant procedure - unknown +D6190,0.00,5.01,611.00,radiographic/surgical implant index by report +D6191,0.00,0.00,0.00,semi-precision abutment - placement +D6192,0.00,0.00,0.00,semi-precision attachment - placement +D6194,0.00,0.00,0.00,abutment supported retainer crown for FPD - titanium and titanium alloys +D6195,0.00,0.00,0.00,abutment supported retainer - porcelain fused to titanium and titanium alloys +D6197,0.00,0.00,0.00,replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis per implant +D6198,0.00,75.00,150.00,remove interim implant component +D6199,0.00,61.46,6180.00,unspecified implant procedure by report +D6200,0.00,0.00,0.00,pontic - unknown +D6201,0.00,0.00,0.00,pontic - unknown +D6204,0.00,0.00,0.00,pontic - unknown +D6205,0.00,0.00,0.00,pontic - indirect resin based composite +D6210,0.00,0.00,0.00,pontic - cast high noble metal +D6211,0.00,0.00,0.00,pontic - cast predominantly base metal +D6212,0.00,0.07,1.00,pontic - cast noble metal +D6213,0.00,0.00,0.00,pontic - unknown +D6223,0.00,0.00,0.00,pontic - unknown +D6240,0.00,17.84,2340.00,pontic - porcelain fused to high noble metal +D6241,0.00,6.65,963.00,pontic - porcelain fused to predominantly base metal +D6242,0.00,13.48,4370.00,pontic - porcelain fused to noble metal +D6243,0.00,0.00,0.00,pontic - porcelain fused to titanium and titanium alloys +D6245,0.00,35.57,5799.50,pontic - porcelain/ceramic +D6246,0.00,49.29,1183.00,pontic - unknown +D6250,0.00,0.00,0.00,pontic - resin with high noble metal +D6251,0.00,0.00,0.00,pontic - resin with predominantly base metal +D6252,0.00,0.00,0.00,pontic - resin with noble metal +D6253,0.00,6.16,350.00,interim pontic - further treatment or completion of diagnosis necessary prior to final impression +D6254,0.00,0.00,0.00,pontic - unknown +D6270,0.00,0.00,0.00,pontic - unknown +D6279,0.00,0.00,0.00,pontic - unknown +D6301,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6319,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6322,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6351,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6356,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6360,320.00,406.00,449.00,prosthodontics - fixed procedure - unknown +D6365,194.00,194.00,194.00,prosthodontics - fixed procedure - unknown +D6372,0.00,27.00,81.00,prosthodontics - fixed procedure - unknown +D6374,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6375,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6376,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6377,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6390,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6393,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6400,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6413,608.00,608.00,608.00,prosthodontics - fixed procedure - unknown +D6415,0.00,10.00,32.00,prosthodontics - fixed procedure - unknown +D6431,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6444,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6455,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6460,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6470,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6475,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6496,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6498,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6499,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6506,0.00,0.00,0.00,retainer - unknown +D6507,0.00,0.00,0.00,retainer - unknown +D6510,0.00,0.00,0.00,retainer - unknown +D6513,128.53,128.53,128.53,retainer - unknown +D6536,0.00,0.00,0.00,retainer - unknown +D6544,0.00,0.00,0.00,retainer - unknown +D6545,0.00,10.71,600.00,retainer - cast metal for resin bonded fixed prosthesis +D6548,0.00,0.00,0.00,retainer - porcelain/ceramic for resin bonded fixed prosthesis +D6549,0.00,0.00,0.00,retainer - for resin bonded fixed prosthesis +D6550,0.00,0.00,0.00,retainer - unknown +D6560,0.00,0.00,0.00,retainer - unknown +D6567,0.00,0.00,0.00,retainer - unknown +D6569,0.00,0.00,0.00,retainer - unknown +D6571,0.00,0.00,0.00,retainer - unknown +D6579,0.00,0.00,0.00,retainer - unknown +D6589,0.00,0.00,0.00,retainer - unknown +D6600,0.00,0.00,0.00,retainer inlay - porcelain/ceramic two surfaces +D6605,0.00,0.00,0.00,retainer inlay - cast predominantly base metal three or more surfaces +D6606,0.00,190.20,951.00,retainer inlay - cast noble metal two surfaces +D6608,0.00,0.00,0.00,retainer onlay - porcelain/ceramic two surfaces +D6609,0.00,0.00,0.00,retainer onlay - porcelain/ceramic three or more surfaces +D6610,0.00,0.00,0.00,retainer onlay - cast high noble metal two surfaces +D6615,0.00,0.00,0.00,retainer onlay - cast noble metal three or more surfaces +D6624,0.00,0.00,0.00,retainer inlay - titanium +D6666,0.00,0.00,0.00,retainer inlay or onlay - unknown +D6682,0.00,0.00,0.00,retainer inlay or onlay - unknown +D6698,0.00,0.00,0.00,retainer inlay or onlay - unknown +D6701,0.00,0.00,0.00,retainer crown - unknown +D6704,315.36,315.36,315.36,retainer crown - unknown +D6707,52.00,52.00,52.00,retainer crown - unknown +D6710,0.00,0.00,0.00,retainer crown - indirect resin based composite +D6720,0.00,0.00,0.00,retainer crown - resin with high noble metal +D6721,0.00,0.00,0.00,retainer crown - resin with predominantly base metal +D6722,0.00,0.00,0.00,retainer crown - resin with noble metal +D6740,0.00,27.28,5799.50,retainer crown - porcelain/ceramic +D6741,0.00,0.00,0.00,retainer crown - unknown +D6742,0.00,170.00,850.00,retainer crown - unknown +D6745,0.00,342.60,1247.00,retainer crown - unknown +D6750,0.00,14.46,4680.00,retainer crown - porcelain fused to high noble metal +D6751,0.00,19.17,1514.00,retainer crown - porcelain fused to predominantly base metal +D6752,0.00,24.84,1820.00,retainer crown - porcelain fused to noble metal +D6754,0.00,0.00,0.00,retainer crown - unknown +D6757,0.00,0.00,0.00,retainer crown - unknown +D6760,0.00,0.00,0.00,retainer crown - unknown +D6761,0.00,0.00,0.00,retainer crown - unknown +D6775,0.00,0.00,0.00,retainer crown - unknown +D6780,0.00,0.00,0.00,retainer crown - 3/4 cast high noble metal +D6781,0.00,0.00,0.00,retainer crown - 3/4 cast predominantly base metal +D6782,0.00,0.00,0.00,retainer crown - 3/4 cast noble metal +D6783,0.00,38.86,1155.53,retainer crown - 3/4 porcelain/ceramic +D6790,0.00,0.03,1.00,retainer crown - full cast high noble metal +D6792,0.00,161.15,2094.00,retainer crown - full cast noble metal +D6793,0.00,5.40,350.00,interim retainer crown - further treatment or completion of diagnosis necessary prior to final impression +D6794,0.00,0.00,0.00,retainer crown - titanium and titanium alloys +D6795,0.00,0.00,0.00,retainer crown - unknown +D6811,0.00,179.00,358.00,prosthodontics - fixed procedure - unknown +D6819,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D6821,0.00,427.33,641.00,prosthodontics - fixed procedure - unknown +D6850,259.00,259.00,259.00,prosthodontics - fixed procedure - unknown +D6900,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6901,54.83,88.62,190.00,unspecified fixed prosthodontic procedur - unknown +D6904,16.00,16.00,16.00,unspecified fixed prosthodontic procedur - unknown +D6910,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6920,0.00,104.00,650.00,connector bar +D6921,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6930,0.00,55.79,6995.00,re-cement or re-bond fixed partial denture +D6931,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6932,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6938,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6940,0.00,0.00,0.01,stress breaker +D6949,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6950,0.00,0.00,0.01,precision attachment +D6953,0.00,119.00,238.00,unspecified fixed prosthodontic procedur - unknown +D6970,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6971,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6972,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6973,0.00,3.19,238.00,unspecified fixed prosthodontic procedur - unknown +D6975,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6976,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6980,0.00,5.20,473.27,fixed partial denture repair necessitated by restorative material failure +D6981,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6984,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6985,0.00,0.00,0.00,pediatric partial denture fixed +D6990,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6992,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6997,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6998,0.00,0.00,0.00,unspecified fixed prosthodontic procedur - unknown +D6999,0.00,51.16,3600.00,unspecified fixed prosthodontic procedure by report +D7000,0.00,0.00,0.00,prosthodontics - fixed procedure - unknown +D7001,0.00,30.92,68.02,oral & maxillofacial surgery procedure - unknown +D7002,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7005,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7007,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7010,22.00,22.00,22.00,oral & maxillofacial surgery procedure - unknown +D7012,0.00,26.20,104.80,oral & maxillofacial surgery procedure - unknown +D7014,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7020,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7026,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7030,0.00,91.02,170.75,oral & maxillofacial surgery procedure - unknown +D7031,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7032,0.00,3.44,86.00,oral & maxillofacial surgery procedure - unknown +D7033,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7034,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7035,0.00,23.30,99.00,oral & maxillofacial surgery procedure - unknown +D7038,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7040,0.00,38.35,83.55,oral & maxillofacial surgery procedure - unknown +D7046,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7048,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7049,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7050,44.89,44.89,44.89,oral & maxillofacial surgery procedure - unknown +D7051,0.00,219.67,659.00,oral & maxillofacial surgery procedure - unknown +D7053,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7057,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7063,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7070,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7071,88.00,88.00,88.00,oral & maxillofacial surgery procedure - unknown +D7077,0.00,43.94,55.00,oral & maxillofacial surgery procedure - unknown +D7080,0.00,156.14,509.00,oral & maxillofacial surgery procedure - unknown +D7086,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7090,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7096,0.00,0.00,0.00,oral & maxillofacial surgery procedure - unknown +D7100,0.00,0.00,0.00,extraction of tooth - unknown +D7102,180.00,180.00,180.00,extraction of tooth - unknown +D7104,0.00,0.00,0.00,extraction of tooth - unknown +D7110,0.00,3.08,300.00,extraction of tooth - unknown +D7111,0.00,378.54,24791.00,extraction coronal remnants - primary tooth +D7112,0.00,16.00,40.29,extraction of tooth - unknown +D7115,0.00,0.00,0.00,extraction of tooth - unknown +D7116,35.00,35.00,35.00,extraction of tooth - unknown +D7118,0.00,0.00,0.00,extraction of tooth - unknown +D7120,0.00,19.07,2899.00,extraction of tooth - unknown +D7124,0.00,0.00,0.00,extraction of tooth - unknown +D7130,0.00,69.49,3046.00,extraction of tooth - unknown +D7136,0.00,0.00,0.00,extraction of tooth - unknown +D7139,0.00,0.00,0.00,extraction of tooth - unknown +D7140,0.00,155.56,164247.00,extraction erupted tooth or exposed root (elevation and/or forceps removal) +D7142,0.00,0.00,0.00,extraction of tooth - unknown +D7144,0.00,13.52,150.00,extraction of tooth - unknown +D7146,0.00,0.00,0.00,extraction of tooth - unknown +D7147,0.00,0.00,0.00,extraction of tooth - unknown +D7148,0.00,0.00,0.00,extraction of tooth - unknown +D7149,0.00,0.00,0.00,extraction of tooth - unknown +D7150,0.00,0.00,0.00,extraction of tooth - unknown +D7160,0.00,0.00,0.00,extraction of tooth - unknown +D7161,0.00,0.00,0.00,extraction of tooth - unknown +D7162,91.33,95.92,114.28,extraction of tooth - unknown +D7170,0.00,0.00,0.00,extraction of tooth - unknown +D7180,0.00,0.00,0.00,extraction of tooth - unknown +D7182,0.00,0.00,0.00,extraction of tooth - unknown +D7186,57.00,57.00,57.00,extraction of tooth - unknown +D7190,0.00,96.67,145.00,extraction of tooth - unknown +D7192,0.00,0.00,0.00,extraction of tooth - unknown +D7199,0.00,0.00,0.00,extraction of tooth - unknown +D7200,0.00,374.52,1872.59,oral surgery - unknown +D7201,0.00,0.00,0.00,oral surgery - unknown +D7204,0.00,0.00,0.00,oral surgery - unknown +D7205,0.00,15.93,31.85,oral surgery - unknown +D7206,0.00,295.20,600.00,oral surgery - unknown +D7208,0.00,0.00,0.00,oral surgery - unknown +D7210,0.00,138.02,154559.00,extraction erupted tooth requiring removal of bone and/or sectioning of tooth and including elevation of mucoperiosteal flap if indicated +D7211,0.00,521.15,3240.00,oral surgery - unknown +D7212,0.00,0.00,0.00,oral surgery - unknown +D7214,0.00,14.71,250.00,oral surgery - unknown +D7215,0.00,0.00,0.00,oral surgery - unknown +D7216,0.00,0.00,0.00,oral surgery - unknown +D7218,0.00,0.00,0.00,oral surgery - unknown +D7220,0.00,587.78,32228.16,removal of impacted tooth - soft tissue +D7221,220.00,220.00,220.00,oral surgery - unknown +D7225,0.00,0.00,0.00,oral surgery - unknown +D7228,0.00,0.00,0.00,oral surgery - unknown +D7230,0.00,352.93,56169.19,removal of impacted tooth - partially bony +D7232,0.00,0.00,0.00,oral surgery - unknown +D7238,0.00,0.00,0.00,oral surgery - unknown +D7240,0.00,480.49,60450.00,removal of impacted tooth - completely bony +D7241,0.00,195.94,11625.02,removal of impacted tooth - completely bony with unusual surgical complications +D7242,0.00,0.00,0.00,oral surgery - unknown +D7243,0.00,0.00,0.00,oral surgery - unknown +D7245,0.00,0.00,0.00,oral surgery - unknown +D7246,0.00,0.00,0.00,oral surgery - unknown +D7248,0.00,0.00,0.00,oral surgery - unknown +D7249,0.00,187.50,375.00,oral surgery - unknown +D7250,0.00,151.51,40834.00,removal of residual tooth roots (cutting procedure) +D7251,0.00,111.02,23877.00,coronectomy - intentional partial tooth removal impacted teeth only +D7252,0.00,0.00,0.00,oral surgery - unknown +D7253,0.00,0.00,0.00,oral surgery - unknown +D7255,0.00,0.00,0.00,oral surgery - unknown +D7258,0.00,0.00,0.00,oral surgery - unknown +D7260,0.00,392.22,8900.00,oroantral fistula closure +D7261,0.00,196.91,26380.00,primary closure of a sinus perforation +D7264,0.00,0.00,0.00,oral surgery - unknown +D7265,0.00,0.00,0.00,oral surgery - unknown +D7266,0.00,8.85,407.00,oral surgery - unknown +D7268,0.00,0.00,0.00,oral surgery - unknown +D7270,0.00,21.76,6293.00,tooth re-implantation and/or stabilization of accidentally evulsed or displaced tooth +D7271,0.00,0.00,0.00,oral surgery - unknown +D7272,0.00,12.31,320.00,tooth transplantation (includes re-implantation from one site to another and splinting and/or stabilization) +D7273,0.00,0.00,0.00,oral surgery - unknown +D7274,0.00,0.00,0.00,oral surgery - unknown +D7275,0.00,0.00,0.00,oral surgery - unknown +D7276,0.00,0.00,0.00,oral surgery - unknown +D7279,0.00,0.00,0.00,oral surgery - unknown +D7280,0.00,0.00,0.00,exposure of an unerupted tooth +D7281,0.00,0.00,0.00,oral surgery - unknown +D7282,0.00,25.61,550.00,mobilization of erupted or malpositioned tooth to aid eruption +D7283,0.00,1.61,100.00,placement of device to facilitate eruption of impacted tooth +D7284,0.00,41.86,293.00,oral surgery - unknown +D7285,0.00,38.55,1500.00,incisional biopsy of oral tissue-hard (bone tooth) +D7286,0.00,28.44,6029.00,incisional biopsy of oral tissue-soft +D7287,0.00,8.34,433.00,exfoliative cytological sample collection +D7288,0.00,10.57,650.00,brush biopsy - transepithelial sample collection +D7289,0.00,37.75,375.00,oral surgery - unknown +D7290,0.00,255.01,36655.00,surgical repositioning of teeth +D7291,0.00,5.36,96.50,transseptal fiberotomy/supra crestal fiberotomy by report +D7292,0.00,273.23,2945.00,placement of temporary anchorage device [screw retained plate] requiring flap +D7293,0.00,0.00,0.00,placement of temporary anchorage device requiring flap +D7294,0.00,3.94,149.86,placement of temporary anchorage device without flap +D7295,0.00,326.10,5704.24,harvest of bone for use in autogenous grafting procedure +D7296,0.00,1055.00,5275.00,corticotomy - one to three teeth or tooth spaces per quadrant +D7297,0.00,0.00,0.00,corticotomy - four or more teeth or tooth spaces per quadrant +D7299,0.00,0.00,0.00,removal of temporary anchorage device requiring flap +D7301,0.00,101.60,400.00,oral surgery - unknown +D7302,0.00,0.00,0.00,oral surgery - unknown +D7304,0.00,0.00,0.00,oral surgery - unknown +D7305,0.00,0.00,0.00,oral surgery - unknown +D7310,0.00,173.18,35526.00,alveoloplasty in conjunction with extractions - four or more teeth or tooth spaces per quadrant +D7311,0.00,267.26,38012.00,alveoloplasty in conjunction with extractions - one to three teeth or tooth spaces per quadrant +D7312,0.00,0.00,0.00,oral surgery - unknown +D7320,0.00,82.28,21316.00,alveoloplasty not in conjunction with extractions - four or more teeth or tooth spaces per quadrant +D7321,0.00,355.85,123480.00,alveoloplasty not in conjunction with extractions - one to three teeth or tooth spaces per quadrant +D7324,0.00,0.00,0.00,oral surgery - unknown +D7330,0.00,0.00,0.00,oral surgery - unknown +D7337,0.00,0.00,0.00,oral surgery - unknown +D7340,0.00,168.37,3702.00,vestibuloplasty - ridge extension (secondary epithelialization) +D7341,0.00,0.00,0.00,oral surgery - unknown +D7350,0.00,47.92,1250.00,vestibuloplasty - ridge extension (including soft tissue grafts muscle reattachment revision of soft tissue attachment and management of hypertrophied and hyperplastic tissue) +D7353,0.00,0.00,0.00,oral surgery - unknown +D7355,0.00,0.00,0.00,oral surgery - unknown +D7360,0.00,0.00,0.00,oral surgery - unknown +D7365,0.00,0.00,0.00,oral surgery - unknown +D7373,0.00,0.00,0.00,oral surgery - unknown +D7380,0.00,0.00,0.00,oral surgery - unknown +D7381,0.00,0.00,0.00,oral surgery - unknown +D7385,0.00,0.00,0.00,oral surgery - unknown +D7386,0.00,225.00,475.00,oral surgery - unknown +D7392,0.00,0.00,0.00,oral surgery - unknown +D7399,0.00,0.00,0.00,oral surgery - unknown +D7400,0.00,0.00,0.00,excision or removal - unknown +D7402,0.00,0.00,0.00,excision or removal - unknown +D7409,0.00,0.00,0.00,excision or removal - unknown +D7410,0.00,54.19,6490.50,excision of benign lesion up to 1.25 cm +D7411,0.00,61.40,17712.67,excision of benign lesion greater than 1.25 cm +D7412,0.00,54.24,3000.00,excision of benign lesion complicated +D7413,0.00,95.76,6912.00,excision of malignant lesion up to 1.25 cm +D7414,0.00,101.43,8037.00,excision of malignant lesion greater than 1.25 cm +D7415,0.00,0.00,0.00,excision of malignant lesion complicated +D7416,0.00,0.00,0.00,excision or removal - unknown +D7419,0.00,0.00,0.00,excision or removal - unknown +D7420,0.00,0.00,0.00,excision or removal - unknown +D7421,0.00,187.20,468.00,excision or removal - unknown +D7422,0.00,0.00,0.00,excision or removal - unknown +D7424,0.00,0.00,0.00,excision or removal - unknown +D7425,0.00,0.00,0.00,excision or removal - unknown +D7426,0.00,0.00,0.00,excision or removal - unknown +D7427,0.00,0.00,0.00,excision or removal - unknown +D7428,0.00,0.00,0.00,excision or removal - unknown +D7430,0.00,5.41,535.00,excision or removal - unknown +D7431,0.00,65.84,1000.00,excision or removal - unknown +D7432,0.00,750.00,3000.00,excision or removal - unknown +D7433,0.00,0.00,0.00,excision or removal - unknown +D7434,0.00,0.00,0.00,excision or removal - unknown +D7436,0.00,0.00,0.00,excision or removal - unknown +D7440,0.00,22.05,542.00,excision of malignant tumor - lesion diameter up to 1.25 cm +D7441,0.00,176.55,3752.50,excision of malignant tumor - lesion diameter greater than 1.25 cm +D7443,0.00,0.00,0.00,excision or removal - unknown +D7450,0.00,77.64,13680.00,removal of benign odontogenic cyst or tumor - lesion diameter up to 1.25 cm +D7451,0.00,336.35,9283.33,removal of benign odontogenic cyst or tumor - lesion diameter greater than 1.25 cm +D7452,0.00,0.00,0.00,excision or removal - unknown +D7453,0.00,225.00,450.00,excision or removal - unknown +D7460,0.00,46.92,2337.66,removal of benign nonodontogenic cyst or tumor - lesion diameter up to 1.25 cm +D7461,0.00,81.09,3527.00,removal of benign nonodontogenic cyst or tumor - lesion diameter greater than 1.25 cm +D7465,0.00,18.18,1200.00,destruction of lesion(s) by physical or chemical method by report +D7466,0.00,40.00,120.00,excision or removal - unknown +D7470,0.00,16.83,875.00,excision or removal - unknown +D7471,0.00,74.32,5175.50,removal of lateral exostosis (maxilla or mandible) +D7472,0.00,190.10,7619.75,removal of torus palatinus +D7473,0.00,67.80,7014.66,removal of torus mandibularis +D7474,0.00,0.00,0.00,excision or removal - unknown +D7480,0.00,60.71,850.00,excision or removal - unknown +D7481,275.98,275.98,275.98,excision or removal - unknown +D7485,0.00,69.54,5979.50,reduction of osseous tuberosity +D7486,0.00,0.00,0.00,excision or removal - unknown +D7488,0.00,0.00,0.00,excision or removal - unknown +D7490,0.00,1734.11,15010.00,radical resection of maxilla or mandible +D7510,0.00,27.76,4188.00,incision and drainage of abscess - intraoral soft tissue +D7511,0.00,18.17,1675.75,incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces) +D7518,0.00,0.00,0.00,incision drainage or removal - unknown +D7520,0.00,169.48,7833.33,incision and drainage of abscess - extraoral soft tissue +D7521,0.00,3.33,315.00,incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces) +D7530,0.00,14.00,525.00,removal of foreign body from mucosa skin or subcutaneous alveolar tissue +D7535,32.25,40.75,45.00,incision drainage or removal - unknown +D7540,0.00,323.59,9272.00,removal of reaction producing foreign bodies musculoskeletal system +D7541,0.00,492.50,985.00,incision drainage or removal - unknown +D7542,28.11,28.11,28.11,incision drainage or removal - unknown +D7550,0.00,23.13,1012.00,partial ostectomy/sequestrectomy for removal of non-vital bone +D7551,0.00,0.00,0.00,incision drainage or removal - unknown +D7553,0.00,0.00,0.00,incision drainage or removal - unknown +D7560,0.00,55.87,2060.00,maxillary sinusotomy for removal of tooth fragment or foreign body +D7562,0.00,0.00,0.00,incision drainage or removal - unknown +D7580,0.00,0.00,0.00,incision drainage or removal - unknown +D7586,0.00,0.00,0.00,incision drainage or removal - unknown +D7590,0.00,0.00,0.00,incision drainage or removal - unknown +D7591,0.00,0.00,0.00,incision drainage or removal - unknown +D7593,0.00,0.00,0.00,incision drainage or removal - unknown +D7597,0.00,103.16,257.90,incision drainage or removal - unknown +D7605,0.00,0.00,0.00,reduction - unknown +D7607,14.88,14.88,14.88,reduction - unknown +D7609,0.00,0.00,0.00,reduction - unknown +D7610,0.00,0.00,0.00,maxilla - open reduction (teeth immobilized if present) +D7612,0.00,0.00,0.00,reduction - unknown +D7613,0.00,0.00,0.00,reduction - unknown +D7614,0.00,0.00,0.00,reduction - unknown +D7616,0.00,0.00,0.00,reduction - unknown +D7620,0.00,108.02,3812.00,maxilla - closed reduction (teeth immobilized if present) +D7621,0.00,0.00,0.00,reduction - unknown +D7626,0.00,0.00,0.00,reduction - unknown +D7630,0.00,244.47,7796.00,mandible - open reduction (teeth immobilized if present) +D7632,0.00,0.00,0.00,reduction - unknown +D7635,0.00,0.00,0.00,reduction - unknown +D7637,0.00,0.00,0.00,reduction - unknown +D7640,0.00,227.18,7287.00,mandible - closed reduction (teeth immobilized if present) +D7644,0.00,0.00,0.00,reduction - unknown +D7650,0.00,211.01,1038.13,malar and/or zygomatic arch - open reduction +D7653,0.00,0.00,0.00,reduction - unknown +D7660,0.00,0.00,0.00,malar and/or zygomatic arch - closed reduction +D7670,0.00,136.99,6695.20,alveolus - closed reduction may include stabilization of teeth +D7671,0.00,293.22,4175.00,alveolus - open reduction may include stabilization of teeth +D7680,0.00,14.90,293.36,facial bones - complicated reduction with fixation and multiple surgical approaches +D7686,0.00,0.00,0.00,reduction - unknown +D7703,0.00,0.00,0.00,reduction - unknown +D7706,0.00,0.00,0.00,reduction - unknown +D7710,0.00,24.70,604.94,maxilla - open reduction +D7720,0.00,234.28,1363.95,maxilla - closed reduction +D7730,0.00,337.47,6412.00,mandible - open reduction +D7740,0.00,70.19,706.20,mandible - closed reduction +D7746,0.00,0.00,0.00,reduction - unknown +D7750,0.00,0.00,0.00,malar and/or zygomatic arch - open reduction +D7760,0.00,32.57,38.00,malar and/or zygomatic arch - closed reduction +D7762,0.00,2.79,67.00,reduction - unknown +D7770,0.00,0.00,0.00,alveolus - open reduction stabilization of teeth +D7771,0.00,0.00,0.00,alveolus closed reduction stabilization of teeth +D7777,0.00,0.00,0.00,reduction - unknown +D7780,0.00,0.00,0.00,facial bones - complicated reduction with fixation and multiple approaches +D7781,0.00,0.00,0.00,reduction - unknown +D7791,0.00,0.00,0.00,reduction - unknown +D7799,0.00,0.00,0.00,reduction - unknown +D7800,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7802,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7803,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7810,0.00,0.00,0.00,open reduction of dislocation +D7820,0.00,15.33,570.00,closed reduction of dislocation +D7826,0.00,102.86,240.00,unspecified TMD therapy - unknown +D7830,0.00,62.03,4280.00,manipulation under anesthesia +D7838,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7840,0.00,0.00,0.00,condylectomy +D7850,0.00,0.00,0.00,surgical discectomy with/without implant +D7853,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7854,0.00,0.00,0.00,synovectomy +D7856,0.00,0.00,0.00,myotomy +D7859,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7860,0.00,0.00,0.00,arthrotomy +D7865,0.00,2022.22,9100.00,arthroplasty +D7870,0.00,6.80,711.00,arthrocentesis +D7871,0.00,9.75,832.00,non-arthroscopic lysis and lavage +D7872,0.00,0.00,0.00,arthroscopy - diagnosis with or without biopsy +D7873,0.00,0.00,0.00,arthroscopy: lavage and lysis of adhesions +D7874,0.00,0.00,0.00,arthroscopy: disc repositioning and stabilization +D7875,0.00,0.00,0.00,arthroscopy: synovectomy +D7877,0.00,0.00,0.00,arthroscopy: debridement +D7880,0.00,71.54,6500.00,occlusal orthotic device by report +D7881,0.00,36.61,2892.00,occlusal orthotic device adjustment +D7882,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7883,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7884,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7886,0.00,0.00,0.00,unspecified TMD therapy - unknown +D7889,0.00,70.45,775.00,unspecified TMD therapy - unknown +D7890,0.00,16.67,100.00,unspecified TMD therapy - unknown +D7895,3100.00,3100.00,3100.00,unspecified TMD therapy - unknown +D7898,0.00,125.00,250.00,unspecified TMD therapy - unknown +D7899,0.00,19.12,4000.00,unspecified TMD therapy by report +D7900,0.00,20.00,40.00,unspecified oral surgery procedure - unknown +D7902,0.00,180.00,900.00,unspecified oral surgery procedure - unknown +D7904,0.00,150.00,299.99,unspecified oral surgery procedure - unknown +D7910,0.00,25.89,1450.00,suture of recent small wounds up to 5 cm +D7911,0.00,92.18,2500.00,complicated suture - up to 5 cm +D7912,0.00,74.42,1079.00,complicated suture - greater than 5 cm +D7916,0.00,3.66,12.00,unspecified oral surgery procedure - unknown +D7920,0.00,0.00,0.00,skin graft (identify defect covered location and type of graft) +D7921,0.00,2.85,506.00,collection and application of autologous blood concentrate product +D7922,0.00,0.10,30.00,placement of intra-socket biological dressing to aid in hemostasis or clot stabilization per site +D7931,0.00,0.00,0.00,unspecified oral surgery procedure - unknown +D7940,0.00,13.20,264.00,osteoplasty - for orthognathic deformities +D7941,0.00,0.00,0.00,osteotomy - mandibular rami +D7943,0.00,0.00,0.00,osteotomy - mandibular rami with bone graft; includes obtaining the graft +D7944,0.00,0.00,0.00,osteotomy - segmented or subapical +D7945,0.00,205.16,3898.00,osteotomy - body of mandible +D7946,0.00,0.00,0.00,LeFort I (maxilla - total) +D7947,0.00,0.00,0.00,LeFort I (maxilla - segmented) +D7948,0.00,0.00,0.00,LeFort II or LeFort III (osteoplasty of facial bones for midface hypoplasia or retrusion) - without bone graft +D7949,0.00,0.00,0.00,LeFort II or LeFort III - with bone graft +D7950,0.00,95.45,4807.00,osseous osteoperiosteal or cartilage graft of the mandible or maxilla - autogenous or nonautogenous by report +D7951,0.00,84.90,11408.48,sinus augmentation with bone or bone substitutes via a lateral open approach +D7952,0.00,27.42,4977.42,sinus augmentation via a vertical approach +D7953,0.00,16.81,10551.25,bone replacement graft for ridge preservation - per site +D7955,0.00,58.02,3500.00,repair of maxillofacial soft and/or hard tissue defect +D7956,0.00,36.89,900.00,guided tissue regeneration edentulous area - resorbable barrier per site +D7957,0.00,0.00,0.00,guided tissue regeneration edentulous area - non-resorbable barrier per site +D7958,0.00,0.00,0.00,unspecified oral surgery procedure - unknown +D7959,0.00,0.00,0.00,unspecified oral surgery procedure - unknown +D7960,0.00,41.82,5979.50,unspecified oral surgery procedure - unknown +D7961,0.00,71.25,5014.80,buccal / labial frenectomy (frenulectomy) +D7962,0.00,378.91,6840.00,lingual frenectomy (frenulectomy) +D7963,0.00,0.01,1.00,frenuloplasty +D7970,0.00,149.55,13232.00,excision of hyperplastic tissue - per arch +D7971,0.00,55.89,3297.74,excision of pericoronal gingiva +D7972,0.00,22.13,622.00,surgical reduction of fibrous tuberosity +D7979,0.00,0.00,0.00,non - surgical sialolithotomy +D7980,0.00,2.57,355.00,surgical sialolithotomy +D7981,0.00,0.00,0.00,excision of salivary gland by report +D7982,0.00,0.00,0.00,sialodochoplasty +D7983,0.00,0.00,0.00,closure of salivary fistula +D7986,0.00,0.00,0.00,unspecified oral surgery procedure - unknown +D7989,0.00,0.00,0.00,unspecified oral surgery procedure - unknown +D7990,0.00,0.00,0.00,emergency tracheotomy +D7993,0.00,0.00,0.00,surgical placement of craniofacial implant - extra oral +D7994,0.00,3201.27,15000.00,surgical placement: zygomatic implant +D7995,0.00,0.00,0.00,synthetic graft - mandible or facial bones by report +D7996,0.00,0.00,0.00,implant-mandible for augmentation purposes (excluding alveolar ridge) by report +D7997,0.00,41.70,5185.00,appliance removal (not by dentist who placed appliance) includes removal of archbar +D7998,0.00,139.77,2376.00,intraoral placement of a fixation device not in conjunction with a fracture +D7999,0.00,41.16,9738.00,unspecified oral surgery procedure by report +D8000,0.00,0.00,0.00,orthodontic treatment - unknown +D8001,0.00,0.00,0.00,orthodontic treatment - unknown +D8010,0.00,0.00,0.00,limited orthodontic treatment of the primary dentition +D8020,0.00,0.00,0.00,limited orthodontic treatment of the transitional dentition +D8040,0.00,0.00,0.00,limited orthodontic treatment of the adult dentition +D8042,0.00,0.00,0.00,orthodontic treatment - unknown +D8048,0.00,0.00,0.00,orthodontic treatment - unknown +D8056,0.00,0.00,0.00,orthodontic treatment - unknown +D8057,0.00,0.00,0.00,orthodontic treatment - unknown +D8060,0.00,0.00,0.00,orthodontic treatment - unknown +D8070,0.00,0.00,0.00,comprehensive orthodontic treatment of the transitional dentition +D8076,0.00,0.00,0.00,orthodontic treatment - unknown +D8080,0.00,0.00,0.00,comprehensive orthodontic treatment of the adolescent dentition +D8081,0.00,0.00,0.00,orthodontic treatment - unknown +D8090,0.00,115.91,8180.00,comprehensive orthodontic treatment of the adult dentition +D8104,0.00,0.00,0.00,orthodontics procedure - unknown +D8108,0.00,0.00,0.00,orthodontics procedure - unknown +D8110,0.00,0.00,0.00,orthodontics procedure - unknown +D8112,450.00,450.00,450.00,orthodontics procedure - unknown +D8114,0.00,0.00,0.00,orthodontics procedure - unknown +D8121,0.00,0.00,0.00,orthodontics procedure - unknown +D8142,133.00,133.00,133.00,orthodontics procedure - unknown +D8189,0.00,0.00,0.00,orthodontics procedure - unknown +D8200,0.00,0.00,0.00,appliance therapy - unknown +D8210,0.00,0.00,1.00,removable appliance therapy +D8211,0.00,0.00,0.00,appliance therapy - unknown +D8220,0.00,0.00,0.00,fixed appliance therapy +D8221,0.00,1324.29,1545.00,appliance therapy - unknown +D8222,450.00,450.00,450.00,appliance therapy - unknown +D8227,0.00,0.00,0.00,appliance therapy - unknown +D8230,0.00,0.00,0.00,appliance therapy - unknown +D8241,0.00,0.00,0.00,appliance therapy - unknown +D8243,375.00,375.00,375.00,appliance therapy - unknown +D8246,0.00,0.00,0.00,appliance therapy - unknown +D8260,0.00,0.00,0.00,appliance therapy - unknown +D8262,0.00,9.85,325.00,appliance therapy - unknown +D8271,153.84,153.84,153.84,appliance therapy - unknown +D8275,162.00,162.00,162.00,appliance therapy - unknown +D8286,0.00,0.00,0.00,appliance therapy - unknown +D8297,0.00,240.58,2042.00,appliance therapy - unknown +D8300,0.00,0.00,0.00,orthodontics procedure - unknown +D8304,0.00,0.00,0.00,orthodontics procedure - unknown +D8305,0.00,97.00,194.00,orthodontics procedure - unknown +D8310,0.00,0.00,0.00,orthodontics procedure - unknown +D8312,0.00,0.00,0.00,orthodontics procedure - unknown +D8337,0.00,0.00,0.00,orthodontics procedure - unknown +D8380,0.00,0.00,0.00,orthodontics procedure - unknown +D8385,0.00,0.00,0.00,orthodontics procedure - unknown +D8391,0.00,0.00,0.00,orthodontics procedure - unknown +D8403,0.00,0.00,0.00,orthodontics procedure - unknown +D8410,0.00,0.00,0.00,orthodontics procedure - unknown +D8420,0.00,0.00,0.00,orthodontics procedure - unknown +D8425,0.00,0.00,0.00,orthodontics procedure - unknown +D8427,0.00,0.00,0.00,orthodontics procedure - unknown +D8428,0.00,0.00,0.00,orthodontics procedure - unknown +D8430,0.00,0.00,0.00,orthodontics procedure - unknown +D8431,0.00,0.01,0.01,orthodontics procedure - unknown +D8437,0.00,0.00,0.00,orthodontics procedure - unknown +D8443,0.00,0.00,0.00,orthodontics procedure - unknown +D8445,0.00,0.00,0.00,orthodontics procedure - unknown +D8447,0.00,0.00,0.00,orthodontics procedure - unknown +D8499,0.00,33.33,50.00,orthodontics procedure - unknown +D8500,0.00,0.00,0.00,orthodontics procedure - unknown +D8501,254.24,254.24,254.24,orthodontics procedure - unknown +D8502,0.00,0.00,0.00,orthodontics procedure - unknown +D8505,0.00,0.00,0.00,orthodontics procedure - unknown +D8539,0.00,0.00,0.00,orthodontics procedure - unknown +D8540,0.00,0.00,0.01,orthodontics procedure - unknown +D8553,0.00,0.17,2.00,orthodontics procedure - unknown +D8562,0.00,0.00,0.00,orthodontics procedure - unknown +D8622,0.00,0.00,0.00,orthodontic treatment - unknown +D8630,0.00,0.00,0.00,orthodontic treatment - unknown +D8640,0.00,0.00,0.00,orthodontic treatment - unknown +D8660,0.00,0.00,0.00,pre-orthodontic treatment examination to monitor growth and development +D8670,0.00,9.10,456.36,periodic orthodontic treatment visit +D8680,0.00,58.68,3685.50,orthodontic retention (removal of appliances construction and placement of retainer(s)) +D8681,0.00,0.00,0.00,removable orthodontic retainer adjustment +D8690,0.00,205.49,4726.25,orthodontic treatment - unknown +D8691,0.00,0.00,0.00,orthodontic treatment - unknown +D8692,0.00,0.00,0.00,orthodontic treatment - unknown +D8693,0.00,0.00,0.00,orthodontic treatment - unknown +D8694,0.00,0.00,0.00,orthodontic treatment - unknown +D8695,0.00,0.00,0.00,removal of fixed orthodontic appliances for reasons other than completion of treatment +D8698,0.00,0.00,0.00,re-cement or re-bond fixed retainer - maxillary +D8699,0.00,4330.92,19489.15,re-cement or re-bond fixed retainer - mandibular +D8701,0.00,0.00,0.00,repair of fixed retainer includes reattachment - maxillary +D8702,0.00,0.00,0.00,repair of fixed retainer includes reattachment - mandibular +D8703,0.00,0.00,0.00,replacement of lost or broken retainer - maxillary +D8704,0.00,0.00,0.00,replacement of lost or broken retainer - mandibular +D8730,0.00,0.00,0.01,retainer replacement or repair - unknown +D8731,0.00,0.00,0.00,retainer replacement or repair - unknown +D8740,0.00,0.00,0.00,retainer replacement or repair - unknown +D8750,0.00,0.00,0.00,retainer replacement or repair - unknown +D8751,0.00,0.00,0.00,retainer replacement or repair - unknown +D8768,0.00,0.00,0.00,retainer replacement or repair - unknown +D8769,0.00,0.00,0.00,retainer replacement or repair - unknown +D8783,0.00,0.00,0.00,retainer replacement or repair - unknown +D8816,0.00,0.00,0.00,orthodontics procedure - unknown +D8861,0.00,0.00,0.00,orthodontics procedure - unknown +D8888,0.00,43.75,350.00,orthodontics procedure - unknown +D8895,0.00,0.00,0.00,orthodontics procedure - unknown +D8898,0.00,0.00,0.00,orthodontics procedure - unknown +D8907,0.00,0.10,1.00,unspecified orthodontic procedure - unknown +D8910,0.00,0.00,0.00,unspecified orthodontic procedure - unknown +D8918,0.00,0.00,0.00,unspecified orthodontic procedure - unknown +D8929,1549.00,1820.33,2363.00,unspecified orthodontic procedure - unknown +D8930,0.00,0.00,0.00,unspecified orthodontic procedure - unknown +D8940,0.00,0.00,0.00,unspecified orthodontic procedure - unknown +D8941,0.00,1.38,40.00,unspecified orthodontic procedure - unknown +D8942,0.00,0.00,0.00,unspecified orthodontic procedure - unknown +D8943,0.00,0.00,0.00,unspecified orthodontic procedure - unknown +D8948,0.00,3.66,80.00,unspecified orthodontic procedure - unknown +D8950,2175.00,2175.00,2175.00,unspecified orthodontic procedure - unknown +D8953,0.00,0.00,0.00,unspecified orthodontic procedure - unknown +D8978,0.00,0.01,0.01,unspecified orthodontic procedure - unknown +D8979,0.00,0.01,0.01,unspecified orthodontic procedure - unknown +D8980,0.00,0.01,0.01,unspecified orthodontic procedure - unknown +D8981,0.01,0.01,0.01,unspecified orthodontic procedure - unknown +D8982,0.00,0.00,0.01,unspecified orthodontic procedure - unknown +D8983,0.00,0.00,0.00,unspecified orthodontic procedure - unknown +D8984,0.01,0.01,0.01,unspecified orthodontic procedure - unknown +D8985,0.01,0.01,0.01,unspecified orthodontic procedure - unknown +D8987,0.00,0.01,0.01,unspecified orthodontic procedure - unknown +D8988,0.00,0.01,0.01,unspecified orthodontic procedure - 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no other services performed +D9431,0.00,0.00,0.00,encounter - unknown +D9432,0.00,0.00,0.00,encounter - unknown +D9433,0.00,0.00,0.00,encounter - unknown +D9440,0.00,6.52,363.00,office visit - after regularly scheduled hours +D9443,0.00,0.00,0.00,encounter - unknown +D9450,0.00,24.09,1666.00,case presentation subsequent to detailed and extensive treatment planning +D9452,0.00,19.00,38.00,encounter - unknown +D9460,0.00,0.00,0.00,encounter - unknown +D9462,0.00,0.00,0.00,encounter - unknown +D9463,130.00,130.00,130.00,encounter - unknown +D9466,0.00,225.00,450.00,encounter - unknown +D9473,0.00,0.00,0.00,encounter - unknown +D9480,0.00,175.00,350.00,encounter - unknown +D9490,0.00,0.00,0.00,encounter - unknown +D9491,0.00,0.00,0.00,encounter - unknown +D9499,0.00,0.00,0.00,encounter - unknown +D9500,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9503,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9504,0.00,0.00,0.00,adjunctive general services procedure - 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unknown +D9633,12.00,12.00,12.00,medication administration - unknown +D9634,0.00,0.00,0.00,medication administration - unknown +D9635,0.00,0.00,0.00,medication administration - unknown +D9636,165.00,165.00,165.00,medication administration - unknown +D9637,0.00,38.84,116.51,medication administration - unknown +D9638,0.00,0.00,0.00,medication administration - unknown +D9640,0.00,0.00,0.00,medication administration - unknown +D9645,0.00,0.00,0.00,medication administration - unknown +D9650,0.00,23.75,95.00,medication administration - unknown +D9679,218.00,218.00,218.00,medication administration - unknown +D9694,0.00,0.00,0.00,medication administration - unknown +D9697,0.00,0.00,0.00,medication administration - unknown +D9700,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9701,0.00,17.81,55.00,adjunctive general services procedure - unknown +D9703,0.00,8.33,25.00,adjunctive general services procedure - unknown +D9704,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9710,0.00,0.00,0.00,adjunctive general services procedure - 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unknown +D9784,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9786,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9799,0.00,320.00,1600.00,adjunctive general services procedure - unknown +D9803,0.00,66.25,137.88,adjunctive general services procedure - unknown +D9810,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9812,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9830,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9871,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9880,425.00,425.00,425.00,adjunctive general services procedure - unknown +D9894,0.00,61.00,75.00,adjunctive general services procedure - unknown +D9898,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9899,0.00,0.00,0.00,adjunctive general services procedure - unknown +D9900,0.00,2.11,35.00,unspecified adjunctive procedure - unknown +D9901,0.00,90.00,180.00,unspecified adjunctive procedure - unknown +D9902,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9905,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9907,0.00,5.43,38.00,unspecified adjunctive procedure - unknown +D9908,12.00,12.00,12.00,unspecified adjunctive procedure - unknown +D9909,0.00,13.33,20.00,unspecified adjunctive procedure - unknown +D9910,0.00,83.27,4048.00,application of desensitizing medicament +D9911,0.00,5.14,109.95,application of desensitizing resin for cervical and/or root surface per tooth +D9912,0.00,0.00,0.00,pre-visit patient screening +D9913,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9915,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9916,0.00,18.00,90.00,unspecified adjunctive procedure - unknown +D9919,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9920,0.00,2.31,5358.33,behavior management by report +D9921,0.00,7.22,187.00,unspecified adjunctive procedure - unknown +D9922,10.83,10.83,10.83,unspecified adjunctive procedure - unknown +D9923,0.00,2.42,70.07,unspecified adjunctive procedure - unknown +D9924,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9928,0.00,122.80,1228.00,unspecified adjunctive procedure - unknown +D9929,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9930,0.00,247.13,5775.00,treatment of complications (post-surgical) - unusual circumstances by report +D9931,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9932,0.00,0.00,0.00,cleaning and inspection of removable complete denture maxillary +D9933,0.00,0.00,0.00,cleaning and inspection of removable complete denture mandibular +D9934,0.00,0.00,0.00,cleaning and inspection of removable partial denture maxillary +D9935,0.00,0.00,0.00,cleaning and inspection of removable partial denture mandibular +D9938,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9939,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9940,0.00,73.50,3176.72,unspecified adjunctive procedure - unknown +D9941,0.00,0.01,1.00,fabrication of athletic mouthguard +D9942,0.00,2.84,250.00,repair and/or reline of occlusal guard +D9943,0.00,0.00,0.00,occlusal guard adjustment +D9944,0.00,23.42,3267.00,occlusal guard - hard appliance full arch +D9945,0.00,5.08,354.00,occlusal guard - soft appliance full arch +D9946,0.00,66.76,1313.00,occlusal guard - hard appliance partial arch +D9947,0.00,24.62,2599.00,custom sleep apnea appliance fabrication and placement +D9948,0.00,0.00,0.00,adjustment of custom sleep apnea appliance +D9949,0.00,28.75,340.00,repair of custom sleep apnea appliance +D9950,0.00,8.57,615.00,occlusion analysis - mounted case +D9951,0.00,48.84,4946.62,occlusal adjustment - limited +D9952,0.00,36.45,2840.72,occlusal adjustment - complete +D9953,0.00,0.00,0.00,reline custom sleep apnea appliance (indirect) +D9954,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9957,0.00,63.33,95.00,unspecified adjunctive procedure - unknown +D9960,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9961,0.00,0.00,0.00,duplicate/copy patient's records +D9962,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9963,0.00,77.86,109.00,unspecified adjunctive procedure - unknown +D9966,0.00,41.37,82.74,unspecified adjunctive procedure - unknown +D9967,3.53,177.27,351.00,unspecified adjunctive procedure - unknown +D9970,0.00,0.03,1.00,enamel microabrasion +D9971,0.00,65.70,2376.50,odontoplasty - per tooth +D9972,0.00,15.33,374.00,external bleaching - per arch - performed in office +D9973,0.00,0.00,0.00,external bleaching - per tooth +D9974,0.00,34.32,79.55,internal bleaching - per tooth +D9975,0.00,0.00,0.00,external bleaching for home application per arch; includes materials and fabrication of custom trays +D9976,0.00,21.50,129.00,unspecified adjunctive procedure - unknown +D9977,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9978,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9979,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9980,0.00,1.67,22.38,unspecified adjunctive procedure - unknown +D9981,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9982,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9983,0.00,0.09,1.00,unspecified adjunctive procedure - unknown +D9984,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9985,0.00,0.00,0.00,sales tax +D9986,0.00,0.00,0.00,missed appointment +D9987,0.00,0.00,0.00,cancelled appointment +D9988,0.00,0.00,0.00,unspecified adjunctive procedure - unknown +D9990,0.00,4.40,22.00,certified translation or sign-language services - per visit +D9991,0.00,3.18,70.00,dental case management - addressing appointment compliance barriers +D9992,0.00,2.18,125.00,dental case management - care coordination +D9993,0.00,19.00,133.00,dental case management - motivational interviewing +D9994,0.00,0.00,0.00,dental case management - patient education to improve oral health literacy +D9995,0.00,69.65,125.00,teledentistry - synchronous; real-time encounter +D9996,0.00,0.00,0.00,teledentistry - asynchronous; information stored and forwarded to dentist for subsequent review +D9997,0.00,2.63,250.00,dental case management - patients with special health care needs +D9998,0.00,12.58,375.00,unspecified adjunctive procedure - unknown +D9999,0.00,108.31,17000.00,unspecified adjunctive procedure by report \ No newline at end of file diff --git a/src/main/resources/synthea.properties b/src/main/resources/synthea.properties index d4d599b9a8..c6677a6a6c 100644 --- a/src/main/resources/synthea.properties +++ b/src/main/resources/synthea.properties @@ -214,6 +214,15 @@ generate.costs.default_lab_cost = 100.00 generate.costs.default_device_cost = 0.00 # -- assumes supply costs are included in procedure cost, if not add to costs/supplies.csv generate.costs.default_supply_cost = 0.00 +# Cost methodology for specified costs (see src/main/resources/costs/*.csv) +# Each cost entry has a "min", "mode", and "max" +# Cost methodology can be one of: EXACT, GAUSSIAN, UNIFORM, EXPONENTIAL, TRIANGULAR +# EXACT: uses the "mode" cost exactly, with a geographic modifier +# GAUSSIAN: picks a cost normally distributed around the "mode" +# UNIFORM: picks a cost uniformly between "min" and "max" +# EXPONENTIAL: picks a cost with average equaling the "mode" +# TRIANGULAR: picks a cost from a triangular distribution with "min", "mode", "max" +generate.costs.method = exponential # Providers generate.providers.hospitals.default_file = providers/hospitals.csv diff --git a/src/test/java/org/mitre/synthea/world/concepts/CostsTest.java b/src/test/java/org/mitre/synthea/world/concepts/CostsTest.java index 4dade6b4ed..e8387784e2 100644 --- a/src/test/java/org/mitre/synthea/world/concepts/CostsTest.java +++ b/src/test/java/org/mitre/synthea/world/concepts/CostsTest.java @@ -3,8 +3,6 @@ import static org.junit.Assert.assertEquals; import static org.junit.Assert.assertTrue; -import java.util.Random; - import org.junit.Before; import org.junit.Test; import org.mitre.synthea.TestHelper; @@ -169,16 +167,4 @@ public void setup() { double expectedCost = Config.getAsDouble("generate.costs.default_medication_cost"); assertEquals(expectedCost, cost, 0.01); // assert the cost is within $0.01 } - - @Test public void testTriangularDistributionLimits() { - Random random = new Random(); - double min = 0; - double max = 1; - double mode = 0.5; - for (int i = 0; i < 10000; i++) { - double value = Costs.CostData.triangularDistribution(min, max, mode, random.nextDouble()); - assertTrue(value >= min); - assertTrue(value <= max); - } - } } \ No newline at end of file