01702 Examination and Diagnosis, Prosthodontic, Specific
| 00000 | DIAGNOSTIC |
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| 01000 | EXAMINATION AND DIAGNOSIS, CLINICAL ORAL |
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| 01700 | EXAMINATIONS AND DIAGNOSIS, PROSTHODONTIC |
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| 01702 | Examination and Diagnosis, Prosthodontic, Specific | $78.94 | $78.94 |