04729 Each additional unit over four

00000

DIAGNOSTIC

04000

TEST/ANALYSIS/LABORATORY PROCEDURES/INTERPRETATION AND/OR REPORTS

04700

SUPPLEMENTARY DIAGNOSTIC PROCEDURES (INTERPRETATION ONLY)

04720

Wax-up, Diagnostic (To Evaluate Cosmetic And/Or Preparation Design And/Or Occlusal
Considerations) (Gnathological Wax-up)

04729 Each additional unit over four $77.9
+Lab Costs
$77.9
+Lab Costs
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