04749 Each additional unit
| 00000 | DIAGNOSTIC |
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| 04000 | TEST/ANALYSIS/LABORATORY PROCEDURES/INTERPRETATION AND/OR REPORTS |
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| 04700 | SUPPLEMENTARY DIAGNOSTIC PROCEDURES (INTERPRETATION ONLY) |
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| 04740 | Interpretation of Diagnostic Casts |
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| 04749 | Each additional unit | $75.04 | $75.04 |