91119 Each additional unit over three
| 90000 | GENERAL SERVICES |
||
| 91000 | UNCLASSIFIED TREATMENTS |
||
| 91100 | UNCLASSIFIED TREATMENT, DENTAL PAIN |
||
| 91110 | Palliative (emergency) Treatment of Dental Pain, Minor Procedure |
||
| 91119 | Each additional unit over three | $107.98 | $107.98 |