78701 Appliance Splint, Maxillary
| 70000 | ORAL MAXILLOFACIAL SURGERY |
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| 78000 | TEMPOROMANDIBULAR JOINT DYSFUNCTIONS, TREATMENT OF |
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| 78700 | TEMPOROMANDIBULAR JOINT, APPLIANCE SPLINTS, ORTHOPEDIC REHABILITATION (post operative) |
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| 78701 | Appliance Splint, Maxillary |
$920.06
+Lab Costs |
$920.06
+Lab Costs |