04943 Custom Incisal Guide Table
| 00000 | DIAGNOSTIC |
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| 04000 | TEST/ANALYSIS/LABORATORY PROCEDURES/INTERPRETATION AND/OR REPORTS |
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| 04900 | CASTS, DIAGNOSTIC (technical procedure only) |
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| 04940 | Casts, Diagnostic, Miscellaneous Procedures |
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| 04943 | Custom Incisal Guide Table |
Independent Consideration
+Lab Costs |
Indep. Consid.
+Lab Costs |