20110 Caries/Trauma/Pain Control
| 20000 | RESTORATION |
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| 20100 | CARIES, TRAUMA AND PAIN CONTROL |
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| 20110 | Caries/Trauma/Pain Control | ||
| Additional Information: | Add'l Info: | (removal of carious lesions or existing restorations or gingivally attached tooth fragment and |
|
| 20111 | First tooth |
83.42 - 166.84 | 83.42 - 166.84 |
| 20119 | Each additional tooth same quadrant |
83.42 - 166.84 | 83.42 - 166.84 |