Class II Services
The following services are paid at 80% of UCR:
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Oral surgery: Surgical extractions and certain other minor surgical procedures, including general anesthesia when administered by a dentist in connection with a covered oral surgery and when given in a dental office
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Restorative: Treatment of tooth decay with amalgam, synthetic porcelain and plastic materials (Refer to "Class III Services" for other restorations.)
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Endodontic: Procedures for pulpal therapy and root canal filling
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Periodontic: Treatment of tissues supporting the teeth, including scaling once every three years.
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