23323 Three 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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23320 | Permanent Molars |
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23323 | Three surfaces | $260.63 | $260.63 |