83102 Appliance, Mandibular
| 80000 | ORTHODONTICS |
||
| 83000 | APPLIANCES, RETENTION, ORTHODONTIC RETAINING APPLIANCES |
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| 83100 | APPLIANCES, REMOVABLE, RETENTION |
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| 83102 | Appliance, Mandibular |
$262.16
+Lab Costs |
$262.16
+Lab Costs |