23500 RESTORATIONS, TOOTH COLOURED/ PLASTIC WITH/WITHOUT SILVER FILINGS, PRIMARY, POSTERIOR, NON BONDED
| 20000 | RESTORATION |
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| 23000 | RESTORATIONS, TOOTH COLOURED/PLASTIC WITH/WITHOUT SILVER FILINGS |
||
| 23500 | RESTORATIONS, TOOTH COLOURED/ PLASTIC WITH/WITHOUT SILVER FILINGS, PRIMARY, POSTERIOR, NON BONDED | ||
| 23501 | One surface |
114.7 | 114.7 |
| 23502 | Two surfaces |
150.16 | 150.16 |
| 23503 | Three surfaces |
173.1 | 173.1 |
| 23504 | Four surfaces |
186.66 | 186.66 |
| 23505 | Five surfaces or maximum surface per tooth |
228.39 | 228.39 |
| 23510 | Restorations, Tooth Colored, Primary, Posterior, Bonded Technique |