04739 Each additional unit over four
00000 | DIAGNOSTIC |
||
04000 | TEST/ANALYSIS/LABORATORY PROCEDURES/INTERPRETATION AND/OR REPORTS |
||
04700 | SUPPLEMENTARY DIAGNOSTIC PROCEDURES (INTERPRETATION ONLY) |
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04730 | Split Cast Mounting, Diagnostic |
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04739 | Each additional unit over four |
$77.9
+Lab Costs |
$77.9
+Lab Costs |