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Internal Bleaching / Tooth 30.00 0.00 5.00 0.00 External Bleaching Full Mouth 120.00 0.00 50.00 0.00 Endodontic Treatment for Anterior teeth / Tooth / 30.00 0.00 5.00 0.00 Endodontic Treatment For Premolar / Tooth / 60.00 0.00 10.00 0.00 Endodontic Treatment for molar / Tooth / 90.00 0.00 15.00 0.00 Re-treatment of Root Canal / Per 1 Canal 35.00 0.00 10.00 0.00 Exploration of Calcified Canal or a Ledge, Additional charge of treatment / 20.00 0.00 5.00 0.00 Removal of Broken Instrument / Additional Charge of Treatment / 20.00 0.00 5.00 0.00 Repair of Perforation 50.00 0.00 15.00 0.00 Retrograde filling with MTA MTA 30.00 0.00 10.00 0.00 Partial Pulpotomy (Permanent Tooth) 20.00 0.00 5.00 0.00 Enamel Micro Abrasion / Tooth 20.00 0.00 5.00 0.00 Inlay / Onlay - Porcelain 90.00 0.00 40.00 0.00 Inlay / Onlay - Precious Metal / 100.00 0.00 50.00 0.00 Inlay / Onlay - Composite 40.00 0.00 15.00 0.00 Porcelain Laminate Veneer /Tooth / 100.00 0.00 40.00 0.00 Metal Free Ceramic Crown / Tooth / 150.00 0.00 60.00 0.00 Metal - Ceramic Crown (Non Precious Metal) / Unit / 110.00 10.00 30.00 1.00 Metal - Ceramic Crown (Precious metal) / Unit / 170.00 0.00 60.00 0.00 Metal Crown (Non Precious - Metal) / Unit / 80.00 10.00 15.00 0.00 Metal Crown (Precious - Metal) / Unit / 120.00 0.00 50.00 0.00 Anterior Casted Post & Core (Non Precious - Metal) / 50.00 5.00 15.00 0.00 Anterior Casted Post & Core (Precious - Metal) / 120.00 0.00 50.00 0.00 Posterior Casted Post & Core (Non Precious - Metal) / 50.00 5.00 15.00 0.00 Posterior Casted Post & Core (Precious - Metal) / 150.00 0.00 50.00 0.00 Ready Made Post 50.00 5.00 10.00 0.00 Non Metal Post 60.00 0.00 10.00 0.00

00.0 00.03 00.01 00.011 / tinU / )lateM suoicerP noN( egdirB cimareC - lateM 00.0 00.06 00.0 00.071 / tinU / )lateM suoicerP( egdirB cimareC - lateM 00.0 00.03 00.5 00.08 / tinU / egdirB dednoB niseR 00.0 00.0 00.0 00.01 nworC enO / levomeR nworC 00.0 00.0 00.0 00.02 )gninoitceS yB( nworC / lavomeR nworC 00.0 00.0 00.0 00.51 lavomeR egdirB 00.0 00.0 00.0 00.03 )gninoitceS yB( lavomeR egdirB 00.0 00.0 00.0 00.02 lavomeR nworC - tsoP 00.0 00.0 00.0 00.01 nworC yraropmeT 00.0 00.051 00.0 00.003 / tinU reP scitehtsorP / tnalpmI latneD 00.4 00.0 00.0 00.0 maglamA I ssalC 00.6 00.0 00.0 00.0 maglamA II ssalC 00.8 00.0 00.0 00.0 3 DOM maglamA 00.5 00.0 00.0 00.0 I ssalC etisopmoC roiretsoP 00.8 00.0 00.0 00.0 II ssalC etisopmoC roiretsoP 00.5 00.0 00.0 00.0 etisopmoC III ssalC 00.8 00.0 00.0 00.0 etisopmoC VI ssalC 00.5 00.0 00.0 00.0 etisopmoC V ssalC 00.01 00.0 00.0 00.0 lanaC enO rof gnilliF P/G htiW tnemtaerT citnododnE 00.05 00.0 00.0 00.0 tinU / )lateM suoicerP noN( nworC cimareC - lateM 00.3 00.0 00.0 00.0 tisiV ycnegremE 00.0 00.0 00.0 00.5 sisongaiD & noitanimaxE 00.0 00.1 00.0 00.8 tnemtaerT enicideM larO dna sisongaiD 00.0 00.1 00.0 00.4 htnom eno nihtiw tnemtaerT enicideM larO weiveR 00.0 00.0 00.0 00.3 yar-X .A.P 00.0 00.2 00.0 00.5 yar-X lasulccO 00.0 00.5 00.5 00.01 yar-X cimaronaP 00.0 00.5 00.5 00.01 yar-X cirtemolahpeC 00.2 00.0 00.0 00.01 cinilC ycnegremE 00.0 00.0 00.0 00.0 tsalpdnaS 00.0 00.0 00.0 00.0 gnitnuoM

00.0 00.0 00.0 00.0 snoitacilpuD 00.0 00.0 00.0 00.0 tsaC ydutS 00.0 00.0 00.0 00.0 pU xaW citsongaiD 00.0 00.0 00.0 00.51 bawS ro raemS lacigolotyC 00.0 00.3 00.0 00.21 ) ) )elpmis( maglamA I ssalC 00.0 00.4 00.0 00.51 ) ) )evisnetxE( maglamA I ssalC 00.0 00.4 00.0 00.51 ) ) )elpmis( maglamA II ssalC 00.0 00.5 00.0 00.02 ) ) )evisnetxE( maglamA II ssalC 00.0 00.5 00.0 00.52 3 DOM maglamA 00.0 00.5 00.0 00.52 llaW gnissiM fo pu dliuB-)maglama xelpmoc( snoitarotseR maglamA 00.0 00.5 00.0 00.52 )gnippaC pluP tceridnI ro tceriD( snoitarotseR maglamA 00.0 00.1 00.0 00.5 gnilliF yraropmeT 00.0 00.5 00.0 00.02 maglamA deniateR-niP 00.0 00.3 00.0 00.01 tsoP citnododnE 00.0 00.4 00.0 00.02 etisopmoC roiretsoP I ssalC 00.0 00.5 00.0 00.52 etisopmoC roiretsoP II ssalC 00.0 00.6 00.0 00.03 DOM etisopmoC roiretsoP 00.0 00.4 00.0 00.51 )( )elpmis( etisopmoC III ssalC 00.0 00.5 00.0 00.52 )( )evisnetxE( setisopmoC III ssalC 00.0 00.5 00.0 00.02 )( )elpmiS( etisopmoC VI ssalC 00.0 00.7 00.0 00.03 )( )evisnetxE( etisopmoC VI ssalC 00.0 00.3 00.0 00.01 )( )elpmiS( etisopmoC V ssalC 00.0 00.5 00.0 00.02 )( )evisnetxE( etisopmoC V ssalC 00.0 00.5 00.0 00.51 )RAC( RRP etisopmoC 00.0 00.7 00.0 00.53 gnicaF setisopmoC 00.0 00.4 00.0 00.01 noitarotseR remonoI ssalG I ssalC 00.0 00.5 00.0 00.51 noitarotseR remonoI ssalG II ssalC 00.0 00.6 00.0 00.02 DOM noitarotseR remonoI ssalG 00.0 00.51 00.5 00.03 sledoM gnidulcnI esaC citnodohtrO fo tnemssessA 00.0 00.05 00.02 00.052 ecnailppA elbavomeR reppU 00.0 00.001 00.02 00.052 EMR wercS noisnapxE

00.0 00.05 00.02 00.052 xileH - dauQ 00.0 00.05 00.02 00.002 rekaerB tibaH 00.0 00.001 00.02 00.004 ecnailppA lanoitcnuF 00.0 00.001 00.05 00.052 tnemtaerT raeg daeH 00.0 00.001 00.05 00.002 4*2 lanoitceS 00.0 00.002 00.0 00.005 / waJ 1 / ecnailppA dexiF 00.0 00.003 00.0 00.007 ) ) esaC etaredoM / ecnailppA dexiF 00.0 00.004 00.0 00.009 ) ) esaC rojaM / ecnailppA dexiF 00.0 00.03 00.02 00.05 ) ) waJ 1 / reniateR 00.0 05.2 00.0 00.5 / tisiV / tnemeganaM roivaheB 00.0 05.7 00.0 00.51 noitacilppA ediroulF 00.0 05.1 00.0 00.3 htooT suoudiceD fo noitcartxE 00.0 05.2 00.0 00.5 / htooT / tnelaeS erussiF 00.0 05.7 00.0 00.51 )RAC - noitarotseR evisehdA evitavresnoC( I RRP 00.0 05.7 00.0 00.51 )RAC - noitarotseR evisahdA evitavresnoC( II RRP 00.0 00.01 00.0 00.02 )RAC - noitarotseR evisehdA evitavresnoC( III RRP 00.0 05.3 00.0 00.21 htooT suoudiceD maglamA I ssalC 00.0 00.6 00.0 00.21 htooT suoudiceD maglamA II ssalC 00.0 05.7 00.0 00.51 3 htooT suoudiceD DOM maglamA 00.0 05.7 00.0 00.51 htooT suoudiceD etisopmoC roiretsoP I ssalC 00.0 00.01 00.0 00.02 htooT suoudiceD roiretsoP II ssalC 00.0 05.21 00.0 00.52 htooT suoudiceD DOM etisopmoC roiretsoP 00.0 05.7 00.0 00.51 htooT suoudiceD etisopmoC III ssalC 00.0 00.01 00.0 00.02 htooT suoudiceD etisopmoC VI ssalC 00.0 00.5 00.0 00.01 htooT suoudiceD etisopmoC V ssalC 00.0 05.21 00.0 00.52 / htooT suoudiceD gnicaF etisopmoC

htooT suoudiceD noitarotseR remonoI ssalG I ssalC /

00.0 00.5 00.0 00.01 00.0 05.7 00.0 00.51 / htooT suoudiceD noitarotseR remonoI ssalG II ssalC 00.0 00.01 00.0 00.02 / htooT suoudiceD DOM noitarotseR remonoI ssalG 00.0 05.7 00.1 00.51 / htooT suoudiceD / nworC leetS sselniatS

00.0 05.21 00.1 00.52 / htooT nenamreP / nworC leetS sselniatS 00.0 05.21 00.0 00.52 nworC pirtS 00.0 00.4 00.0 00.8 htooT suoudiceD - ymotopluP 00.0 05.7 00.0 00.51 htoot suoudiceD - YMOTCEPLUP 00.0 05.2 00.0 00.5 / tisiv / noitacifixepA ro odnE / gnisserD mirtnI 00.0 05.21 00.0 00.52 hteeT dezitamuarT fo gnitnilpS 00.0 00.03 00.0 00.06 / waJ enO / reniatniaM ecapS 00.0 05.7 00.0 00.51 egrahC lanoitiddA / noitadeS rednU tnemtaerT 00.0 00.51 00.0 00.03 reniatniaM ecapS laretalinU 00.0 00.06 00.0 00.021 nerdlihC rof hteet roiretnA fo tnemecalpeR dexiF 00.0 05.21 00.0 00.52 lanaC enO / gnillif P/G htiw tnemtaerT citnododnE 00.0 05.7 00.0 00.51 noitacifixepA 00.0 00.2 00.0 00.02 silupE fo lavomeR 00.0 00.1 00.0 00.51 / waJ 1 / gnihsiloP & gnilacS 00.0 00.5 00.0 00.52 6 tnardauQ / gninnalP tooR 00.0 00.2 00.0 00.05 / htooT / gninehtgneL nworC 00.0 00.5 00.0 00.51 htoot / ymotcevigniG 00.0 00.5 00.0 00.51 htoot / ytsalpovigniG 00.0 00.5 00.0 00.03 palF latnodoireP 00.0 00.5 00.0 00.08 htooT enO / )GTC ro GGF( tfarG lavigniG 00.0 00.5 00.0 00.03 htooT noitceseR ro noitcesimeH 00.0 00.5 00.0 00.05 htooT / tfarG enoB 00.0 00.5 00.0 00.52 )D( etisopmoC yB hteeT desimorpmoC yllatnodoireP fo gnitnilpS 00.0 00.03 00.0 00.57 hteeT 6 pU setalP lateM yb hteeT fo gnitnilpS 00.0 00.5 00.0 00.07 )C( noitarenegeR eussiT dediuG 00.0 00.5 00.0 00.53 gninoitidnoC / noitaraperP tooR 00.0 00.0 00.0 00.5 noitazitisneseD 00.0 00.01 00.2 00.02 / tfoS / drauG thgiN 00.0 00.01 00.2 00.05 / draH / drauG thgiN 00.0 00.51 00.5 00.03 htooT enO htiw DPR cilyrcA 00.0 00.0 00.0 00.5 DPR nO htooT lanoitiddA hcaE roF egrahC lanoitiddA

Acrylic Complete Denture / 2 Jaw 200.00 10.00 50.00 0.00 Cr - Co RPD / 1 Jaw / 200.00 10.00 50.00 0.00 Cr - Co / 2 Jaw / 400.00 0.00 100.00 0.00 Relining for Denture 50.00 0.00 5.00 0.00 Rebase for One Denture 50.00 0.00 10.00 0.00 Repairing Acrylic Denture Complete or PD 10.00 1.00 2.00 0.00 Prosthetic Precision Attachment / Unit / C 100.00 0.00 20.00 0.00 Obturator 350.00 0.00 70.00 0.00 Arylic Complete Denture / 1 Jaw 100.00 10.00 25.00 0.00 Simple Extraction 10.00 0.00 0.00 0.00 Extraction With Root Separation 20.00 0.00 0.00 0.00 Simple Extraction of A Remaining root 25.00 0.00 0.00 0.00 Surgical Extraction of A Remaining Root 50.00 0.00 5.00 0.00 Extraction of A Soft Tissue Impacted Tooth 50.00 0.00 5.00 0.00 Extraction of Half Bony Impacted Tooth 75.00 0.00 8.00 0.00 Extraction of Full Bony Impacted Tooth 100.00 0.00 10.00 0.00 Surgical Exposure of A Soft Tissue Impacted Tooth 40.00 0.00 5.00 0.00 Surgical Exposure of Bony Impacted Tooth 60.00 0.00 8.00 0.00 Simple Alveoplasty 40.00 0.00 0.00 0.00 Complex Alveoplasty / Quadrant / 50.00 0.00 5.00 0.00 Maxillary Tubeosity Reduction 50.00 0.00 5.00 0.00 Mylohyoid Ridge Reduction / Side / 75.00 0.00 0.00 0.00 Genial Tubercle Reduction 75.00 0.00 0.00 0.00 Removal of Maxillary Tori 75.00 0.00 5.00 0.00 Removal of Mandibular Tori 75.00 0.00 5.00 0.00 Reduction of Hypermobile Soft Tissue 50.00 0.00 5.00 0.00 Labial Frenectomy 50.00 0.00 5.00 0.00 Lingual Frenectomy 75.00 0.00 5.00 0.00 Jaw Augmentation With Bone Graft / 1 Jaw / 150.00 0.00 0.00 0.00 Jaw Augmentation With Alloplastic Material 120.00 0.00 0.00 0.00 Sulcus Deepening / Quadrant / 80.00 0.00 0.00 0.00

Indirect Sinus Lift / side ) ) 100.00 0.00 0.00 0.00 Direct Sinus Lift / Side ) ) 300.00 0.00 0.00 0.00 Intraoral Incision And Drainage 30.00 0.00 0.00 0.00 Simple Extraoral Incision And Drainage 50.00 0.00 5.00 0.00 Apicectomy of Anterior Tooth 80.00 0.00 5.00 0.00 Apicectomy of Posterior Tooth 100.00 0.00 10.00 0.00 Surgical Treatment of Osteomyelitis 150.00 0.00 0.00 0.00 Closure of Oro-Antral Fistula 120.00 0.00 15.00 0.00 Cald Well Luc Approach ) ) 150.00 0.00 0.00 0.00 Removal of A Stone From Salivary Gland Duct 80.00 0.00 10.00 0.00 Excision of Sublingual Gland / Ranula 100.00 0.00 0.00 0.00 Excision of A Mucocele 40.00 0.00 5.00 0.00 Closed Reduction of TMJ Dislocation 30.00 0.00 3.00 0.00 Closed Reduction & Fixation of A Fractured Jaw 200.00 0.00 0.00 0.00 Interdental Wiring 70.00 0.00 10.00 0.00 Removal of Interdental Wiring 30.00 0.00 5.00 0.00 Intermaxillary Fixation (IMF) 150.00 0.00 15.00 0.00 Removal of IMF 50.00 0.00 5.00 0.00 Suturing of Minor Facial Lacerations 100.00 0.00 5.00 0.00 Soft Tissue Biopsy 30.00 0.00 5.00 0.00 Bone Biopsy 70.00 0.00 0.00 0.00 Fine Needle Aspiration 60.00 0.00 0.00 0.00 Excision With Primary Closure / Small Lession 50.00 0.00 0.00 0.00 Excision With Primary Closure / Large Lession 100.00 0.00 0.00 0.00 First Stage Implant Surgery Per IMPLANT 300.00 0.00 150.00 0.00 Second Stage Implant Surgery Per IMPLANT 50.00 0.00 25.00 0.00 Ridge Augmentation Without A Membrane 100.00 0.00 0.00 0.00 Ridge Augmentation With A Membrane 150.00 0.00 0.00 0.00 Jaw Cyst Enucleation / Up to 3 cm 3 100.00 0.00 15.00 0.00 Jaw Cyst Enucleation / More than 3 cm 3 150.00 0.00 0.00 0.00 Excision of Sebaceous Cyst 90.00 0.00 0.00 0.00

00.0 00.2 00.0 00.02 ymotcelucrepO