13400 SEALANTS, PIT AND FISSURE (Mechanical and/or chemical preparation included)
| 10000 | PREVENTION |
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| 13000 | PREVENTIVE SERVICES, OTHER |
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| 13400 | SEALANTS, PIT AND FISSURE (Mechanical and/or chemical preparation included) | ||
| 13401 | First tooth |
34.06 | 34.06 |
| 13409 | Each additional tooth same quadrant |
17.03 | 17.03 |
| 13410 | Preventive Restorative Resin (procedure that involves some preparation of the pits and/or fissures |