405 IAC 5-14-4
405 IAC 5-14-4 Topical fluoride
Cite as Ind. Admin. Code tit. 405, r. 5-14-4
Sec. 4. Reimbursement is available for one (1) topical application of fluoride every six (6) months per member from the time of first tooth
eruption. Topical applications of fluoride are not covered for members twenty-one (21) years of age or older. Brush-in fluoride (topical application
of fluoride phosphate) is not a covered service.