01502 Examination and Diagnosis, Periodontal, Limited (previous patient)
| 00000 | DIAGNOSTIC |
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| 01000 | EXAMINATION AND DIAGNOSIS, CLINICAL ORAL |
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| 01500 | EXAMINATION AND DIAGNOSIS, PERIODONTAL |
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| 01502 | Examination and Diagnosis, Periodontal, Limited (previous patient) | $155.8 | $155.8 |