20130 Trauma Control, Smoothing of Fractured Surfaces Per Tooth
| 20000 | RESTORATION |
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| 20100 | CARIES, TRAUMA AND PAIN CONTROL |
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| 20130 | Trauma Control, Smoothing of Fractured Surfaces Per Tooth | ||
| 20131 | First tooth |
44.95 | 44.95 |
| 20139 | Each additional tooth same quadrant |
40.77 | 40.77 |