23314 Four surfaces
20000 | RESTORATION |
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23000 | RESTORATIONS, TOOTH COLOURED/PLASTIC WITH/WITHOUT SILVER FILINGS |
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23300 | RESTORATIONS, TOOTH COLORED, PERMANENT POSTERIORS - BONDED |
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23310 | Permanent Bicuspids |
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23314 | Four surfaces | $300.86 | $300.86 |