Page 6 - Dental HMO
P. 6
5"#
#,"! . 0 ............................................................................... 12( !!
#,"# 7<& . 0 ......................................................................... 12( !!
#,#! ...................................................................................... 1#&( !!
#,#" ......................................................................... 1"&( !!
#,## ............................................................................................. 1"2( !!
#,&! < .................................................................................................... 1#3( !!
#,(! .......................................................................... 1#3( !!
#,(" ............................................................. 1"3( !!
#,(# ................................................................................. 1#7( !!
#,2! 7<& ........................................................................................ 1#*! !!
#,2" 7<& ........................................................................... 1"*! !!
#,2# 7<& ............................................................................................... 1#!! !!
#,27 7<& < .............................................................................................. 1#3( !!
#,3! ......................................................................................... 1#*! !!
#,3" ............................................................................ 1"*! !!
#,3# ................................................................................................ 1#!! !!
#,3& ................................................................................................................. 1#3( !!
#3"! - + + $ $ ................................... 1"! !!
#3"( - ................................ 1"! !!
#3#! - ................................................................................................ 1"! !!
#3#" - + ............................................... 1&! !!
#3#3 < .............................................. 17! !!
#37! ................................................................. 1#( !!
#37" ............................................................. 1#( !!
#37# .................................................................. 17( !!
#377 ............................ 17! !!
#3&! $ ........................................................................................................... 1"! !!
#3&" 6 .................................................................. 1"! !!
#3&3 - $ .................................................................... 1#! !!
#3(! + = ...................................................................... 1#! !!
#3(" + .................................................................. 1"( !!
#3(# + ................... 1*! !!
#3(7 8 .................... 1&( !!
#3(& , ( ..... 1&( !!
#3(, 8 , ( ...... 17( !!
#3," 5 : .............. 173 !!
#32! $ .......................................................... 1#! !!
#32" 6 $ ............................................................. 1#! !!
#32# ) $ ........................................................... 1#! !!
#327 9 $ ......................................................... 1#! !!
#33! - ! ! * . 1"! !!
6,,, 6... 15# 2 / /2$1
7""! . 0 ......................................................................... %
7"#! . 0 ....................................................................... %
7##! . 0 $
........................................................ 1"( !!
7##" + .................................................................. 1#! !!
7### $ ........... 1"( !!
7#7! . 0 + . 0 ................ 17! !!
7#&! . 0 + . 0 .............. 17! !!
77"! 1 + . 0 ............................... 12( !!
77#! 1 + . 0 ............................. 1"(! !!
777! 1 + . 0 .................................. 1#2! !!
777" / ......................................................... 12( !!
777# 6 / + ............................... 12( !!
7777 6 .............................................................................. 12( !!
6 $ &$ 67' 5 &$ % 9
#,"! . 0 ............................................................................... 12( !!
#,"# 7<& . 0 ......................................................................... 12( !!
#,#! ...................................................................................... 1#&( !!
#,#" ......................................................................... 1"&( !!
#,## ............................................................................................. 1"2( !!
#,&! < .................................................................................................... 1#3( !!
#,(! .......................................................................... 1#3( !!
#,(" ............................................................. 1"3( !!
#,(# ................................................................................. 1#7( !!
#,2! 7<& ........................................................................................ 1#*! !!
#,2" 7<& ........................................................................... 1"*! !!
#,2# 7<& ............................................................................................... 1#!! !!
#,27 7<& < .............................................................................................. 1#3( !!
#,3! ......................................................................................... 1#*! !!
#,3" ............................................................................ 1"*! !!
#,3# ................................................................................................ 1#!! !!
#,3& ................................................................................................................. 1#3( !!
#3"! - + + $ $ ................................... 1"! !!
#3"( - ................................ 1"! !!
#3#! - ................................................................................................ 1"! !!
#3#" - + ............................................... 1&! !!
#3#3 < .............................................. 17! !!
#37! ................................................................. 1#( !!
#37" ............................................................. 1#( !!
#37# .................................................................. 17( !!
#377 ............................ 17! !!
#3&! $ ........................................................................................................... 1"! !!
#3&" 6 .................................................................. 1"! !!
#3&3 - $ .................................................................... 1#! !!
#3(! + = ...................................................................... 1#! !!
#3(" + .................................................................. 1"( !!
#3(# + ................... 1*! !!
#3(7 8 .................... 1&( !!
#3(& , ( ..... 1&( !!
#3(, 8 , ( ...... 17( !!
#3," 5 : .............. 173 !!
#32! $ .......................................................... 1#! !!
#32" 6 $ ............................................................. 1#! !!
#32# ) $ ........................................................... 1#! !!
#327 9 $ ......................................................... 1#! !!
#33! - ! ! * . 1"! !!
6,,, 6... 15# 2 / /2$1
7""! . 0 ......................................................................... %
7"#! . 0 ....................................................................... %
7##! . 0 $
........................................................ 1"( !!
7##" + .................................................................. 1#! !!
7### $ ........... 1"( !!
7#7! . 0 + . 0 ................ 17! !!
7#&! . 0 + . 0 .............. 17! !!
77"! 1 + . 0 ............................... 12( !!
77#! 1 + . 0 ............................. 1"(! !!
777! 1 + . 0 .................................. 1#2! !!
777" / ......................................................... 12( !!
777# 6 / + ............................... 12( !!
7777 6 .............................................................................. 12( !!
6 $ &$ 67' 5 &$ % 9
