Pricing Sheet.pdf

This file is a dental services pricing sheet listing various dental procedures with their corresponding service codes. The pricing sheet includes detailed entries for different types of dental treatments such as surface ant/posterior fills (with 1, 2, 3, and 4+ surface variations), root canal treatments (for premolars, molars, and anterior teeth), tooth extractions (simple, surgical, wisdom tooth), core build-up, pulp vitality tests, crowns (porcelain and stainless steel), and other procedural codes like FMD D4355. The sheet is designed as a template with a "Description" column and an adjacent blank "Cost" column, indicating that potential dental service providers would fill in their specific pricing for each listed procedure as part of their proposal for the Indiana National Guard dental surgical services contract.