13410 Preventive Restorative Resin (procedure that involves some preparation of the pits and/or fissures in tooth enamel and may extend into dentin in limited areas)
| 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) |
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| 13410 | Preventive Restorative Resin (procedure that involves some preparation of the pits and/or fissures in tooth enamel and may extend into dentin in limited areas) | ||
| 13411 | First tooth |
75.74 | 75.74 |
| 13419 | Each additional tooth same quadrant |
71.56 | 71.56 |