DMO Dental Benefits Summary - ih-aetna
DMO Dental Benefits Summary Member Services 877-238-6200 Effective Date: 01-01-2015 PROCEDURE PROCEDURE D6065 $185 D6790 $185 D6066 $185 D6791 $185 D6067 $185 D6792 $185 D6068 $185 D6794 $185 D6069 $185 D6930 $15 D6070 $185 D6970 $50 D6071 $185 D6972 $60 D6072 $