Difficult removal of old crown and bridgework per tooth or abutment tooth. ? 35,20. R91*. Root cap with pin. ? 176,00. R92. Fit restorative test setup in the ...

Replacing tooth or molar, first element. ? 70,40. H55. Replacing tooth or molar, next element in the same session. ? 21,12. Page 8. Lassus Tandartsen. T. +31 (0) ...

finish. Smooth cavo-surface margin. Minor roughness of cavo- surface margin. Moderate roughness of cavo-surface margin. Gross roughness of cavo- surface margin.

Cl sign of a cracked tooth. Cusps of posterior teeth may. c l inically appear to be firmly in position, with no fracture l :etectable by mirror and explorer ...

no fee shall be payable under item 15(a) or 15(d) to repair or replace a root filling where the same dentist provided the original root filling to the same ...

examan

... CT W/CONTRAST. 0042T. $954.00. 0054T. BONE SURGERY USING COMPUTER ASSIST, FLURO ... ABDOMEN. 15830. $4,198.00. 15832. PR EXCISE EXCESS SKIN TISSUE,THIGH. 15832.

D2799 Is not to be used as a temporary ... Services delivered to the patient on the date of service are documented separately using the applicable procedure codes ...

Please use the Comprehensive Dental Reference Guide when preparing your claims and pre-treatment estimates for CareFirst BlueCross BlueShield and CareFirst ...

Reimbursement Rules .................................................................................................. ... Basic Reimbursement ...