机构名称：
¥ 1.0
• Occlusal adjustment, (other than with an appliance or by restoration) • Root planing and scaling, 1 to 3 teeth per quadrant, (1 per site every 2 policy years) • Root planing and scaling, 4 or more teeth per quadrant, (4 separate quadrants every 2 policy years) • Surgical revision procedure, per tooth • Gingivectomy/gingivoplasty, 1 to 3 teeth per quadrant, (1 per站点每2个政策年）•牙龈切除术/牙龈成形术，每象限4牙齿（每3个象限1个），每3个政策年）•牙龈皮瓣程序，每象限1至3个牙齿（每3个象限1个）（每3个政策年度1个政策年）•每象牙齿的牙齿牙齿4或更多的牙齿，•每3个plation flations•ap ap ap apty plations•ap apty plations•ap the unshy dectrate•ap ap plationder• （由其他人以外的人或他们的员工）
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