| Item Number | Description | Schedule Fee |
|---|---|---|
| 75048 | Permanent dentition treatment—2 arch (mandibular and maxillary) treatment (correction and alignment) using orthodontic fixed appliances or aligners, including supply of appliances or aligners—each subsequent 3 months of active treatment (including all adjustments and maintenance, and removal of the appliances) after the initial three months of active treatment for a maximum of a further 33 months |
$332.55 |
| Total: | $332.55 | |