97120 Bleaching, Vital Home (Includes The Fabrication Of Bleaching Trays, Dispensing The System and Follow-up Care)
| 90000 | GENERAL SERVICES |
||
| 97000 | BLEACHING, VITAL |
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| 97120 | Bleaching, Vital Home (Includes The Fabrication Of Bleaching Trays, Dispensing The System and Follow-up Care) | ||
| 97121 | Maxillary Arch |
250.29
+Lab Costs +Material Expenses |
250.29
+Lab Costs +Mater. Exp. |
| 97122 | Mandibular Arch |
250.29
+Lab Costs +Material Expenses |
250.29
+Lab Costs +Mater. Exp. |