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ADJUNCTIVE GENERAL SERVICES | ANESTHESIA | January 1, 2026

ADMINISTRATION OF NITROUS OXIDE

ANESTHESIA | January 1, 2026

NON-INTRAVENOUS CONSCIOUS SEDATION

OTHER PREVENTIVE SERVICES | January 1, 2025

NUTRITIONAL COUNSELING FOR CONTROL OF DENTAL DISEASE

MISCELLANEOUS SERVICES | January 1, 2025

INTERNAL BLEACHING – PER TOOTH

DRUGS | January 1, 2025

INFILTRATION OF SUSTAINED RELEASE THERAPEUTIC DRUG, PER QUADRANT