D0120
Periodic oral evaluation
(Routine exam checking oral health)
D0140
LIMITED ORAL EVALUATION
(PROBLEM FOCUSD EXAM)
D0150
COMPREHENSIVE ORAL EVALUATION
(NEW OR ESTABLISHED PT)
D0210
INTRAORAL COMPLETE SERIES
FULL MOUTH X RAYS
D0274
BITEEING X RAYS
4 IMAGES
D1110
PROPHYLAXIS
ADULT CLEANING
D1120
PROPHYLAXIS
CHILD CLEANING
D1206
TOPICAL FLUORIDE VARNISH
APPLICATION
D1351
SEALANT PER TOOTH
D2140
AMALGAM FiLLING
1 SURFACE
D2330
RESIN BASED COMPOSITE FILLING
1 SURFACE
ANTERIOR ANTERIOR ANTERIOR
D2391
RESIN BASED COMPOSITE FILLING
1 SURFACE
POSTERIOR
POSTERIOR
POSTERIOR
D2740
CROWN
PORCELAIN/CERAMIC
D2950
CORE BUILDUP
(FOUDATION FOR A CROWN)
D3310
ENDODONTIC THERAPY
ANTERIOR TOOTH
ROOT CANAL
D4341
PERIODONTAL SCALING & ROOT PLANING
(PER QUAD)
SRP
D4910
PERIODONTAL MAINTENANCE
D7140
EXTRACTION
ERUPTED TOOTH
OR
EXPOSED TOOTH
D7210
SURGICAL REMOVAL
OF
ERUPTED TOOTH
D9944
OCCUSAL GUARD
(HARD APPLIANCE)