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PROCEDURE DESCRIPTION
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YOUR UCR FEE
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PERIODIC ORAL EXAM
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$ .00
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LIMITED ORAL EXAM=PROBLEM FOCUSED
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$ .00
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COMPREHENSIVE ORAL EXAM
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$ .00
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PROBLEM FOCUSED EXAM-DETAILED AND EXTENSIVE
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$ .00
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X-RAYS-COMPLETE SERIES
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$ .00
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X-RAYS- 1 PERIAPICAL
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$ .00
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X-RAYS-2 BITEWINGS
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$ .00
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X-RAYS-4 BITEWINGS
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$ .00
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VERTICAL BITEWING 7 to 8 X-RAYS
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$ .00
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PANORAMIC X-RAY
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$ .00
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CEPHALOMETRIC
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$ .00
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PHOTOS / IMAGES
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$ .00
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DIAGNOSTIC MODELS
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$ .00
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BRUSH BIOPSY
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$ .00
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DIAGNODENT TESTS
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$ .00
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PROPHY-ADULT (ROUTINE CLEANING)
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$ .00
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PROPHY-CHILD (UNDER 14)
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$ .00
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FLUORIDE -CHILD
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$ .00
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NUTRITIONAL COUNSELING
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$ .00
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TOBACCO CESSATION COUNSELING
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$ .00
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ORAL HYGIENE INSTRUCTION
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$ .00
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SEALANT /TOOTH
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$ .00
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SPACE MAINTAINER-FIXED=UNILATERAL
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$ .00
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SPACE MAINTAINER-FIXED=BILATERAL
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$ .00
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REMOVAL-FIXED SPACE MAINTAINER
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$ .00
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AMALGAM-1 SURFACE
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$ .00
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AMALGAM-2 SURFACE
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$ .00
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AMALGAM-3 SURFACE
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$ .00
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AMALGAM-4+ SURFACE
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$ .00
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RESIN-1 SURFACE-ANTERIOR
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$ .00
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RESIN-2 SURFACE-ANTERIOR
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$ .00
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RESIN-3 SURFACE-ANTERIOR
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$ .00
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RESIN-4+SURFACE OR INCISAL EDGE
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$ .00
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RESIN-1 SURFACE-POSTERIOR
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$ .00
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RESIN-2 SURFACE-POSTERIOR
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$ .00
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RESIN-3 SURFACE-POSTERIOR
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$ .00
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INLAY-1 SURFACE-METALLIC
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$ .00
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ONLAY-3 SURFACE-METALLIC
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$ .00
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INLAY- 1 SURFACE-PORCELAIN /CERAMIC
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$ .00
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ONLAY- 2 SURFACE-PORCELAIN /CERAMIC
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$ .00
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ONLAY- 3 SURFACE-PORCELAIN /CERAMIC
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$ .00
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ONLAY- 4+ SURFACE-PORCELAIN /CERAMIC
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$ .00
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INLAY-1 SURFACE-COMPOSITE/LAB
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$ .00
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ONLAY-3 SURFACE-COMPOSITE/LAB
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$ .00
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CROWN - RESIN / LAB
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$ .00
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CROWN PORCELAIN-CERAMIC
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$ .00
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CROWN PORCELAIN/HIGH NOBLE METAL
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$ .00
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CROWN PORCELAIN/BASE METAL
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$ .00
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CROWN PORCELAIN/NOBLE METAL
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$ .00
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CROWN HIGH NOBLE METAL (GOLD)
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$ .00
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CROWN-TITANIUM
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$ .00
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RECEMENT CROWN
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$ .00
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PREFAB STAINLESS STEEL CROWN=PRIM.
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$ .00
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PREFAB STAINLESS STEEL CROWN=ADULT
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$ .00
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PREFAB RESIN CROWN |
$ .00
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SEDATIVE FILLING
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$ .00
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CORE (+PINS)
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$ .00
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POST/PREFAB
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$ .00
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LABIAL VENEER-RESIN-DIRECT |
$ .00 |
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LABIAL VENEER-PORCELAIN/LAB
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$ .00
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FIT NEW CROWN TO EXISTING RPD
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$ .00
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PULP CAP-DIRECT
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$ .00
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PULP CAP-INDIRECT
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$ .00
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PULPOTOMY
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$ .00
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PULP DEBRIDEMENT
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$ .00
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ROOT CANAL-ANTERIOR
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$ .00
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ROOT CANAL-BICUSPID
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$ .00
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ROOT CANAL-MOLAR
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$ .00
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GINGIVECTOMY/QUAD
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$ .00
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GINGIVAL FLAP / QUAD
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$ .00
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OSSEOUS SURGERY/QUAD
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$ .00
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BONE REPLACEMENT GRAFT
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$ .00
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GUIDED TISSUE REGENERATION
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$ .00
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PERIODONTAL SCALING/QUAD
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$ .00
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FULL MOUTH DEBRIDEMENT
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$ .00
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CHEMOTHERAPY TO TISSUE/TOOTH
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$ .00
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PERIO MAINTENANCE
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$ .00
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DENTURE-COMPLETE-MAXILLARY
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$ .00
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DENTURE-COMPLETE-MANDIBULAR
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$ .00
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IMMEDIATE DENTURE-MAXILLARY
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$ .00
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IMMEDIATE DENTURE-MANDIBULAR
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$ .00
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PARTIAL DENTURE-MAX/RESIN BASE
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$ .00
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PARTIAL DENTURE-MAND/RESIN BASE
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$ .00
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PARTIAL DENTURE-MAX/METAL FRAME
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$ .00
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PARTIAL DENTURE-MAND/METAL FRAME
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$ .00
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MAX RPD - FLEX BASE
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$ .00
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MAND RPD - FLEX BASE
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$ .00
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DENTURE ADJUSTMENT
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$ .00
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REPAIR COMPLETE DENTURE BASE
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$ .00
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REPLACE 1 DENTURE TOOTH
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$ .00
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ADD 1 TOOTH ON PARTIAL DENTURE
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$ .00
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ADD CLASP ON PARTIAL DENTURE
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$ .00
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REBASE MAX DENTURE/LAB
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$ .00
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RELINE MAX DENTURE/OFFICE
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$ .00
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PRECISION ATTACHMENT
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$ .00
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IMPLANT- SURGICAL/ENDOSTEAL
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$ .00
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ABUTMENT- PREFAB
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$ .00
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ABUTMENT SUPPORTED CERAMIC CROWN
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$ .00
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ABUTMENT SUPPORTED PORC-HIGH NOBLE CROWN
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$ .00
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ABUTMENT SUPPORTED RETAINER FOR PORCELAIN/CERAMIC
FPD
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$ .00
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PONTIC/FPD- HIGH NOBLE METAL
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$ .00
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PONTIC/FPD- PORCELAIN/HIGH NOBLE
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$ .00
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PONTIC/FPD- PORCELAIN/BASE METAL
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$ .00
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CROWN FPD PORCELAIN/CERAMIC
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$ .00
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CROWN/FPD-RETAINER PORC/HIGH NOBLE
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$ .00
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CROWN/FPD-RETAINER PORC/BASE METAL
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$ .00
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CROWN/FPD-RETAINER HIGH NOBLE
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$ .00
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RECEMENT BRIDGE (FIXED PARTIAL DENT)
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$ .00
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PRECISION ATTACHMENT - FPD |
$ .00
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EXTRACTION - ERUPTED TOOTH
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$ .00
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SURGICAL EXTRACTION-ERUPTED
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$ .00
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SURGICAL EXTRACTION-SOFT TISSUE
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$ .00
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SURGICAL EXTRACTION-PARTIAL BONY
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$ .00
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SURGICAL EXTRACTION-COMPLETE BONY
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$ .00
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SURGICAL EXTRACTION- ROOT TIP
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$ .00
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ALVEOLOPLASTY-NON EXTRACTION/QUAD
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$ .00
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OCCLUSAL ORTHOTIC DEVISE/TMD
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$ .00
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ORTHODONTIC-PRIMARY/LIMITED
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$ .00
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ORTHODONTIC-INTERCEPTIVE/TRANSITION
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$ .00
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ORTHODONTIC-COMPREHENSIVE/TRANSIT
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$ .00
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ORTHODONTIC-COMPREHENSIVE/ADOLES
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$ .00
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ORTHODONTIC-COMPREHENSIVE/ADULT
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$ .00
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ORTHO EVALUATION-PRE TREATMENT
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$ .00
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ORTHODONTIC RETAINER
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$ .00
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PALLIATIVE TREATMENT FOR PAIN
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$ .00
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LOCAL ANESTHESIA
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$ .00
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ANALGESIA=NITROUS OXIDE
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$ .00
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ELECTRICAL ANESTHESIA-TENS
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$ .00
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OFFICE VISIT AFTER SCHEDULED HOURS
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$ .00
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DESENSITIZING MEDICATION
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$ .00
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OCCLUSAL GUARD
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$ .00
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ATHLETIC MOUTHGUARD
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$ .00
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OCCLUSAL ANALYSIS
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$ .00
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OCCLUSAL ADJUSTMENT=LIMITED
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$ .00
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OCCLUSAL ADJUSTMENT=COMPLETE
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$ .00
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ENAMEL MICROABRASION
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$ .00
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ODONTOPLASTY
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$ .00
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BLEACH/EXT/ARCH
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$ .00
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