• Use this information when speaking with your insurance company

  • Treatment/ServicesCode
    BotoxJO585
    Home Sleep Test95806
    Initial Consultation99202 99203 99204 99205
    Follow-up Visit99212 99213 99214 99215
    Occipital Nerve Block64405
    Oral Airway DeviceE0486
    Sphenopalantine Nerve Block64505
    Trigger Point Injections20553
    Trigeminal Nerve Block64400
    TMJ Injections20605
  • Non-Covered BenefitsPrice
    Nightguard/Splint$1800 - $3000
    Quick Splint$100