Revised 2019

REPAIRS TO PARTIAL DENTURES | January 1, 2025

REPAIR OR REPLACE BROKEN RETENTIVE/CLASPING MATERIALS – PER TOOTH

ANESTHESIA | September 16, 2024

EVALUATION FOR MODERATE SEDATION, DEEP SEDATION OR GENERAL ANESTHESIA

OTHER SURGICAL PROCEDURES | September 16, 2024

PLACEMENT OF DEVICE TO FACILITATE ERUPTION OF IMPACTED TOOTH

PARTIAL DENTURES (INCLUDING ROUTINE POST-DELIVERY CARE) | September 16, 2024

MAXILLARY PARTIAL DENTURE – RESIN BASE (INCLUDING RETENTIVE/CLASPING MATERIALS, RESTS AND TEETH)

PARTIAL DENTURES (INCLUDING ROUTINE POST-DELIVERY CARE) | September 16, 2024

MANDIBULAR PARTIAL DENTURE – RESIN BASE (INCLUDING RETENTIVE/CLASPING MATERIALS, RESTS, AND TEETH)