| D0120 | Periodic oral evaluation - established patient | Diagnostic | I. Diagnostic |
| D0150 | Comprehensive oral evaluation - new or established patient | Diagnostic | I. Diagnostic |
| D0210 | Intraoral - complete series of radiographic images | Diagnostic | I. Diagnostic |
| D0220 | Intraoral - periapical first radiographic image | Diagnostic | I. Diagnostic |
| D0274 | Bitewings - four radiographic images | Diagnostic | I. Diagnostic |
| D0330 | Panoramic radiographic image | Diagnostic | I. Diagnostic |
| D1110 | Prophylaxis - adult | Preventive | II. Preventive |
| D1120 | Prophylaxis - child | Preventive | II. Preventive |
| D1206 | Topical application of fluoride varnish | Preventive | II. Preventive |
| D1351 | Sealant - per tooth | Preventive | II. Preventive |
| D2140 | Amalgam - one surface, primary or permanent | Restorative | III. Restorative |
| D2150 | Amalgam - two surfaces, primary or permanent | Restorative | III. Restorative |
| D2391 | Resin-based composite - one surface, posterior - permanent | Restorative | III. Restorative |
| D2392 | Resin-based composite - two surfaces, posterior - permanent | Restorative | III. Restorative |
| D2740 | Crown - porcelain/ceramic | Restorative | III. Restorative |
| D2750 | Crown - porcelain fused to high noble metal | Restorative | III. Restorative |
| D2950 | Core buildup, including any pins when required | Restorative | III. Restorative |
| D3310 | Endodontic therapy, anterior tooth (excluding final restoration) | Endodontics | IV. Endodontics |
| D3320 | Endodontic therapy, premolar tooth (excluding final restoration) | Endodontics | IV. Endodontics |
| D3330 | Endodontic therapy, molar tooth (excluding final restoration) | Endodontics | IV. Endodontics |
| D4341 | Periodontal scaling and root planing - four or more teeth per quadrant | Periodontics | V. Periodontics |
| D4355 | Full mouth debridement to enable a comprehensive oral evaluation and diagnosis on a subsequent visit | Periodontics | V. Periodontics |
| D4910 | Periodontal maintenance | Periodontics | V. Periodontics |
| D5110 | Complete denture - maxillary | Prosthodontics | VI. Prosthodontics |
| D5120 | Complete denture - mandibular | Prosthodontics | VI. Prosthodontics |
| D5213 | Maxillary partial denture - cast metal framework with resin denture bases | Prosthodontics | VI. Prosthodontics |
| D6010 | Surgical placement of implant body: endosteal implant | Oral Surgery | VII. Oral & Maxillofacial Surgery |
| D7140 | Extraction, erupted tooth or exposed root | Oral Surgery | VII. Oral & Maxillofacial Surgery |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth | Oral Surgery | VII. Oral & Maxillofacial Surgery |
| D7230 | Removal of impacted tooth - partially bony | Oral Surgery | VII. Oral & Maxillofacial Surgery |