ADA CODE & APPROX DISCOUNT FEE AS OF 10/2000

0120 PERIODIC ORAL EVALUATION 29
0140 LMTD ORAL EVALUATION 29
0150 COMPR.ORAL EVALUATION 29
0160 DETAILED ORAL EVALUATION 29
0210 XRAY-COMPLETE SERIES 78
0220 XRAY-SINGLE FILM 20
0230 XRAY-ADDITIONAL FILM 4
0240 XRAY-SINGLE FILM 29
0250 XRAY-SINGLE FILM 52
0260 XRAY-ADDITIONAL FILM 26
0270 BITEWING-XRAY 12
0272 BITEWING-XRAYS 22
0274 BITEWING-XRAYS 33
0290 POST/ANTER LAT FILM 100
0321 OTHER TMJ FILM 65
0330 PANORAMIC FILM 78
0340 CEPHALOMETRIC FILM 167
0415 BACTERIAL CULTURES 35
0425 SUSCEPTIBILITY TEST 68
0460 PULP TESTS 19
0470 DIAGNOSTIC CASTS 52
0501 HISTOPATHOLOGIC EXAM 134
0502 OTHER ORAL PATHOLOGY 85
1110 PROPHYLAXIS (ADULT) 41
1120 PROPHYLAXIS (CHILD) 29
1201 FLUORIDE W/PROPHY CHILD 55
1203 FLUORIDE TREAT CHILD 28
1204 FLUORIDE TREAT ADULT 28
1205 FLUORIDE W/PROPHY ADULT 64
1351 SEALANT (PER TOOTH) 20
1510 SPACE MAINTAINER UNILATERAL 160
1515 SPACE MAINTAINER BILATERAL 160
1520 SPACE MAINTAINER UNILATERAL 160
1525 SPACE MAINTAINER BILATERAL 155
1550 RECEMENT SPACE MAINTAINER 28
2110 AMALGAM RESTORATION 1 SURF 29
2120 AMALGAM RESTORATION 2 SURF 42
2130 AMALGAM RESTORATION 3 SURF 55
2131 AMALGAM RESTORATION 55
2140 AMALGAM RESTORATION 36
2150 AMALGAM RESTORATION 50
2160 AMALGAM RESTORATION 68
2161 AMALGAM RESTORATION 68
2330 RESIN RESTORATION 50
2331 RESIN RESTORATION 78
2332 RESIN RESTORATION 130
2335 RESIN RESTORATION 90
2380 RESIN RESTORATION 50
2381 RESIN RESTORATION 78
2382 RESIN RESTORATION 130
2385 COMPOSIT RESTORATION 50
2386 COMPOSIT RESTORATION 78
2387 COMPOSIT RESTORATION 130
2410 GLD FOIL RESTORATION 130
2420 GLD FOIL RESTORATION 194
2430 GLD FOIL RESTORATION 231
2510 INLAY METALLIC 160
2520 INLAY METALLIC 180
2530 INLAY METALLIC 223
2543 ONLAY METALLIC 3 SURFACES 270
2544 ONLAY METALLIC 4 SURF 270
2610 PORCELAIN INLAY 194
2620 PORCELAIN INLAY 219
2630 PORCELAIN INLAY 273
2642 ONLAY PORC/2 SURFACE 240
2643 ONLAY PORC/3 SURFACE 295
2644 ONLAY PORC/4/MORE SUR 295
2652 INLAY COMP/3 SURF 248
2662 ONLAY COMP/RSIN 2 SUR (LAB) 45
2663 ONLAY COMP/RSIN 3 SUR (LAB) 45
2664 ONLAY-COMP/RSIN 4 SUR 45
2710 CROWN RESIN LAB 270
2720 CROWN RESIN HI NOBLE 339
2721 CROWN RESIN BASE MTL 339
2722 CROWN RESIN NOBL MTL 369
2740 PORCELAIN CROWN 448
2750 CROWN PORC HI NOBLE 448
2751 CROWN PORC BASE MTL 448
2752 CROWN PORC NOBLE MTL 448
2790 CROWN FL CAST HI NBL 295
2791 CROWN FL CST BSE MTL 321
2792 CROWN FL CST NBL MTL 347
2910 RECEMENT INLAY 28
2920 RECEMENT CROWN 28
2930 STAINL STEEL CROWN 105
2931 STAINL STEEL CROWN 105
2932 RESIN CROWN PREFAB 194
2940 SEDATIVE FILLING 24
2950 CROWN BUILDUP 130
2951 PIN RETENTION 78
2952 CAST POST & CORE 130
2954 POST & CORE PREFABB 130
2960 LAMINATE 180
2961 RESIN LAMINATE 180
2962 PORC LAMINATE 180
2980 CROWN REPAIR 105
3110 PULP CAP DIRECT 35
3120 PULP CAP INDIRECT 35
3220 PULPOTOMY 69
3230 PULPAL THERAPY ANTERIOR 138
3240 PULPAL THERAPY POSTERIOR 69
3310 ROOT CANAL THERAPY 255
3320 ROOT CANAL THERAPY 337
3330 ROOT CANAL THERAPY 424
3346 RETREAT ROOT CANAL 305
3347 RETREAT ROOT CANAL 386
3348 RETREAT ROOT CANAL 473
3351 APEXIFICATION 325
3410 APICOECTOMY ANTERIOR 200
3411 APICOECTOMY 200
3425 APICOECTOMY 1 ST ROOT 200
3426 APICOECTOMY ADD ROOT 47
3430 RETROGRADE FILLING 117
3440 APICAL CURETTAGE 83
3450 ROOT AMPUTATION 228
3460 ENDOSSEOUS IMPLANT 649
3910 TOOTH ISOLATION 67
3920 HEMISECTION 228
3940 RECALCIF OF PERF 83
3950 CANAL PREP/FIT POST 34
4210 GINGIVECTOMY 279
4211 GINGIVECTOMY 200
4220 GINGIVAL CURETTAGE 83
4240 GINGIVAL FLAP PROCEDURE 265
4260 OSSEOUS SURGERY 337
4264 BONE GRAFT ADDL SITE 491
4266 GUIDED TISSUE REGEN 245
4267 GUIDED TISSUE NONRESTORABLE 245
4270 PEDICLE SOFT TISSUE GRAFT 205
4271 FREE SOFT TISSUE GRAFT 245
4272 REPOSITIONED FLAP 813
4273 CONNECTIVE TISSUE GRAFT 245
4274 DISTAL/PROXIMAL WEDGE 279
4320 PROVISIONAL SPLINT-INTRA 136
4321 PROVISIONAL SPLINT-EXTR 136
4341 PERIO-SCALING/QUAD 35
4355 F/M DEBRIDE-PERIO EVAUDIA 69
4381 LOCAL CHEMO.AGENT 157
4910 PERIO MAINTENANCE 69
4920 DRESSING CHANGE 28
5110 COMPLETE DENTURE UPPR 872
5120 COMPLETE DENTURE LOW 872
5130 IMMEDIATE DENTURE UP 774
5140 IMMEDIATE DENTURE LO 774
5211 UP PART DENTURE/RESIN BASE 481
5212 LO PART DENTURE/RESIN BASE 481
5213 UP PARTIAL DENTURE-CAST METAL 898
5214 LO PARTIAL DENTURE-CAST METAL 898
5281 UNILATERAL PARTIAL 112
5410 ADJUST DENTURE UPPER-COMPLETE 28
5411 ADJUST DENTURE LOWER-COMPLETE 28
5421 ADJUST DENTURE UPPER-PARTIAL 28
5422 ADJUST DENTURE LOWER-PARTIAL 28
5510 REPAIR COMPLETE DENT 69
5520 REPL BKN MISS TEETH 19
5610 REPAIR RESIN BASE 69
5620 REPAIR FRAMEWORK 85
5630 REPAIR BROKEN CLASP 19
5640 REPLACE BROKEN TEETH 19
5650 ADD TOOTH To PARTIAL 141
5660 ADD CLASP TO PARTIAL 169
5710 REBASE DENTURE UPPER-COMPLETE 288
5711 REBASE DENTURE LOWER-COMPLETE 288
5720 REBASE PARTIAL UPPER-PARTIAL 202
5721 REBASE PARTIAL LOWER-PARTIAL 202
5730 RELINE UPPER DENTURE 85
5731 RELINE LOWER DENTURE 85
5740 RELINE PARTIAL DENT 103
5741 RELINE PARTIAL DENT 103
5750 RELINE UPPER DENTURE 200
5751 RELINE LOWER DENTURE 200
5760 RELINE PARTIAL DENT 160
5761 RELINE PARTIAL DENT 160
5850 TISSUE CONDITIONING-UPPER 85
5860 OVERDENTURE COMPLETE 776
5861 OVERDENTURE PARTIAL 716
5931 SURGICAL OBTURATOR 716
5932 POST SURG OBTURATOR 716
6010 SURGICAL END IMPLANT 649
6020 ABUTMENT END IMPLANT 649
6080 IMPLANT MAINTENANCE 111
6210 PONTIC HI NBLE METAL 226
6211 PONTIC BASE METAL 275
6212 PONTIC NOBLE METAL 297
6240 PONTIC PORC HI NOBLE 449
6241 PONTIC PORC BASE MTL 449
6242 PONTIC PORC NBLE MTL 449
6250 PONTIC RESIN HI NBLE 311
6251 PONTIC RESIN BSE MTL 311
6252 PONT RESIN NOBLE MTL 311
6520 INLAY METALLIC-2 SURF 226
6530 INLAY METALLIC-3 SURF 279
6543 FIXED PARTIAL ONLAY 337
6544 FIXED PARTIAL MOLARS 337
6545 CAST METAL RETAINER 122
6720 BIR CROWN HI NOBLE 424
6721 BR CROWN BASE METAL 424
6722 BR CROWN NOBLE METAL 424
6750 BIR CROWN PORC HI NBL 560
6751 BIR CROWN PORC BSE MTL 560
6752 BR CROWN PORC NBL MTL 560
6780 BR CROWN 3/4 HI NBLE 337
6790 BR CROWN CAST Hl NBL 367
6791 BR CROWN CST BSE MTL 275
6792 BR CROWN CST NBL MTL 297
6930 RECEMENT BRIDGE 57
6940 STRESS BREAKER 80
6970 CAST POST & CORE 439
6971 CAST POST 162
6972 PREFAB POST & CORE 168
7110 EXTRACTION-SINGLE TOOTH 46
7120 EXTRACTION-EACH ADDITIONAL TH 35
7130 ROOT REMOVAL EXPOSED 98
7210 SURGICAL EXTRACTION 98
7220 SURG EXT SOFT TISSUE 98
7230 SURGICAL EXT PT BONY 141
7240 SURGICAL EXT BONY 226
7241 SURG EXTRACT C/BONY DIFFICULT 237
7250 RESIDUAL RT REMOVAL 98
7260 ORAL ANTRAL FISTULA 337
7270 TOOTH REPLANTATION 536
7272 TOOTH TRANSPLANTATION 402
7280 SURGICAL EXPOSURE 85
7281 SURGICAL EXPOSURE 169
7285 HARD TISSUE BIOPSY 169
7286 SOFT TISSUE BIOPSY 106
7290 REPOSITION OF TEETH 169
7291 TRANSSEPT FIBEROTOMY 339
7310 ALVEOPLASTY W/EXT 69
7320 ALVEOPLASTY NO EXT 103
7340 VESTIBULOPLASTY 119
7350 VESTIBULOPLASTY 1003
7410 EXCISION/LESION UNDER 1.25 CM 169
7420 EXCISION/LESION OVER 1.25 CM 337
7430 EXCISION/TUMOR UNDER 1.25 Cm 169
7431 EXCISION/TUMOR OVER 1.25 CM 337
7440 EXCISION OF TUMOR 504
7441 EXCISION OF TUMOR 670
7450 REMOVAL CYST/TUMOR- UNDER 1.25 CM 135
7451 REMOVAL CYST/TUMOR OVER 1.25 CM 268
7460 REMOVAL CYST/TUMOR UNDER 1.25 CM 169
7461 REMOVAL CYST/TUMOR OVER 1.25 CM 337
7465 LESION DESTRUCTION 169
7480 OSTEOTOMY 1671
7490 MANDIBLE RESECTION 1695
7510 I & D OF ABSCESS-INTRAORAL 69
7520 I & D OF ABSCESS-EXTRAORAL 69
7530 REMOVAL OF FRGN BODY 69
7540 REMOVAL OF FRGN BODY 169
7550 SEQUESTRECTOMY 237
7560 SINUSOTOMY 337
7610 FRACTURE TREATMENT 1671
7620 FRACTURE TREATMENT 1003
7630 FRACTURE TREATMENT 1671
7640 FRACTURE TREATMENT 1003
7650 FRACTURE TREATMENT 1003
7660 FRACTURE TREATMENT 169
7670 FRACTURE TREATMENT 504
7680 FRACTURE TREATMENT 1339
7710 FRACTURE TREATMENT 1671
7720 FRACTURE TREATMENT 1003
7730 FRACTURE TREATMENT 1671
7740 FRACTURE TREATMENT 1003
7750 FRACTURE TREATMENT 1003
7760 FRACTURE TREATMENT 169
7770 WRACTURE TREATMENT 670
7780 FRACTURE TREATMENT 1671
7810 DISLOCATION TREATMENT 1339
7820 DISLOCATION TREATMENT 169
7830 DISLOCATION TREATMENT 135
7840 CONDYLECTOMY 1671
7850 MENISECTOMY 2090
7860 ARTHROTOMY 1671
7870 ARTHROCENTESIS 69
7880 OCCLUS ORTHOTIC APPL 788
7910 SUTURE WOUND 69
7911 SUTURE WOUND 471
7912 SUTURE WOUND 1003
7920 SKIN GRAFT 337
7940 OSTEOPLASTY 2785
7950 ORALSURGERY 1504
7955 REPAIR MAXfLLOFACIAL 1671
7960 FRENULECTOMY 103
7970 EXCISION OF TISSUE 169
7980 SIALOLITHOTOMY 103
7981 EXCISION OF GLAND 670
7982 SIALODOCHOPLASTY 1173
7983 CLOSURE OF FISTULA 1339
7990 TRACHEOTOMY 670
7995 SYNTHETIC GRAFT 491
7996 AUGMENTATION IMPLANT 649
9110 PALLIATIVE TREATMENT 28
9220 GEN ANESTHESIA 30MIN 85
9221 GEN ANESTHESIA 15MIN 85
9310 PROF. CONSULTATION 69
9410 HOUSE CALL 28
9420 HOSPITAL CALL 28
9430 OFFICE VISIT-REG HRS 28
9440 OFFICE VISIT-AFT HRS 28
9610 THERAPEUTIC DRUGINJ 28
9630 OTHER DRUGS 28
9910 DESENSITIZ MEDIC 28
9920 BEHAVIOR MANAGEMENT 28
9930 COMPLICATIONS 41
9940 OCCLUSAL GUARDS 28
9950 OCCLUSION ANALYSIS 435
9951 OCCLUSAL ADJ-LTD 69
9952 OCCLUSAL ADJ-COMPLETE 408
9970 ENAMEL ABRASION 69