20111 First tooth
| 20000 | RESTORATION |
||
| 20100 | CARIES, TRAUMA AND PAIN CONTROL |
||
| 20110 | Caries/Trauma/Pain Control |
||
| 20111 | First tooth | $83.42 - 166.84 | $83.42 - 166.84 |
| 20000 | RESTORATION |
||
| 20100 | CARIES, TRAUMA AND PAIN CONTROL |
||
| 20110 | Caries/Trauma/Pain Control |
||
| 20111 | First tooth | $83.42 - 166.84 | $83.42 - 166.84 |