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ADJUNCTIVE GENERAL SERVICES | MISCELLANEOUS SERVICES | January 1, 2025

PLACEMENT OF A CUSTOM REMOVABLE CLEAR PLASTIC TEMPORARY AESTHETIC APPLIANCE

ADJUNCTIVE GENERAL SERVICES | MISCELLANEOUS SERVICES | January 1, 2025

FABRICATION OF A CUSTOM REMOVABLE CLEAR PLASTIC TEMPORARY AESTHETIC APPLIANCE

ORAL & MAXILLOFACIAL SURGERY | OTHER SURGICAL PROCEDURES | January 1, 2025

EXCISIONAL BIOPSY OF MINOR SALIVARY GLANDS

EXTRACTIONS (INCLUDES LOCAL ANESTHESIA, SUTURING, IF NEEDED, AND ROUTINE POSTOPERATIVE CARE) | January 1, 2025

REMOVAL OF IMPACTED TOOTH – COMPLETELY BONY

OTHER RESTORATIVE SERVICES | RESTORATIVE | January 1, 2025

BAND STABILIZATION – PER TOOTH