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OTHER PREVENTIVE SERVICES | January 1, 2025

APPLICATION OF CARIES ARRESTING MEDICAMENT – PER TOOTH

MISCELLANEOUS SERVICES | January 1, 2025

EXTERNAL BLEACHING – PER TOOTH

MISCELLANEOUS SERVICES | January 1, 2025

INTERNAL BLEACHING – PER TOOTH

OTHER REPAIR PROCEDURES | January 1, 2025

SURGICAL REDUCTION OF FIBROUS TUBEROSITY

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

EXTRACTION, CORONAL REMNANTS – PRIMARY TOOTH