12112 Gel or Foam
| 10000 | PREVENTION |
||
| 12100 | FLUORIDE TREATMENTS (whole mouth) |
||
| 12110 | Topical, whole mouth, in office |
||
| 12112 | Gel or Foam | $30.26 | $30.26 |
| 10000 | PREVENTION |
||
| 12100 | FLUORIDE TREATMENTS (whole mouth) |
||
| 12110 | Topical, whole mouth, in office |
||
| 12112 | Gel or Foam | $30.26 | $30.26 |