34442 Maxillary Bicuspid
| 30000 | ENDODONTICS |
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| 34000 | PERIAPICAL SERVICES |
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| 34400 | SURGICAL SERVICES, MISCELLANEOUS |
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| 34440 | Surgery, Endodontic, Exploratory |
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| 34442 | Maxillary Bicuspid | $371.67 | $371.67 |