| Medicaid:
New York State- 1991 |
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| n | Examples |
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| n | FMS
15.00 31.50 |
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| n | Child
Prophylaxis 7.00 14.50 |
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| n | Pulpotomy
13.00 25.00 |
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| n | Orthodontics
1600.00 2500.00 |
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| n | Sealant,
PCR 25.00 |
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| n | Diagnosis and Prevention |
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| n | Oral
Exam 10.00 |
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| n | Radiographs 31.50 |
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| n | Dental
prophylaxis 15.40 |
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| n | Fluoride
treatment 12.00 |
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