RESTORATIVE

OTHER RESTORATIVE SERVICES | RESTORATIVE | January 1, 2026

REMOVAL OF AN INDIRECT RESTORATION ON A NATURAL TOOTH

OTHER RESTORATIVE SERVICES | January 1, 2026

PLACEMENT OF INTERIM DIRECT RESTORATION

OTHER RESTORATIVE SERVICES | January 1, 2026

INTERIM THERAPEUTIC RESTORATION – PRIMARY DENTITION

RESIN-BASED COMPOSITE RESTORATIONS - DIRECT | RESTORATIVE | January 1, 2026

RESIN-BASED COMPOSITE – ONE SURFACE, POSTERIOR

AMALGAM RESTORATIONS (INCLUDING POLISHING) | January 1, 2026

AMALGAM – ONE SURFACE, PRIMARY OR PERMANENT