| D1201 |
topical
application of fluoride (including prophylaxis) - child |
| D1203 |
topical
application of fluoride (prophylaxis not included) - child |
| D1204 |
topical
application of fluoride (prophylaxis not included) - adult |
| D1205 |
topical
application of fluoride (including prophylaxis) - adult |
| D1310 |
nutritional
counseling for control of dental disease |
| D1320 |
tobacco
counseling for the control and prevention of oral disease |
| D1330 |
oral
hygiene instructions |
| D1351 |
sealant
- per tooth |
| D1510 |
space
maintainer - fixed - unilateral |
| D1515 |
space
maintainer - fixed - bilateral |
| D1520 |
space
maintainer - removable - unilateral |
| D1525 |
space
maintainer - removable - bilateral |
| D1550 |
recementation
of space maintainer |
| D2110 |
amalgam
- one surface, primary |
| D2120 |
amalgam
- two surfaces, primary |
| D2130 |
amalgam
- three surfaces, primary |
| D2131 |
amalgam
- four or more surfaces, primary |
| D2140 |
amalgam
- one surface, permanent |