52311 Maxillary
| 50000 | PROSTHODONTICS - REMOVABLE |
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| 52000 | DENTURES, PARTIAL, ACRYLIC |
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| 52300 | DENTURES, PARTIAL, ACRYLIC, WITH METAL WROUGHT/CAST CLASPS AND/OR RESTS |
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| 52310 | Dentures, Partial, Acrylic, with Metal Wrought/Cast Clasps and/or Rests, |
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| 52311 | Maxillary |
$818.45
+Lab Costs |
$818.45
+Lab Costs |