04729 Each additional unit over four
| 00000 | DIAGNOSTIC |
||
| 04000 | TEST/ANALYSIS/LABORATORY PROCEDURES/INTERPRETATION AND/OR REPORTS |
||
| 04700 | SUPPLEMENTARY DIAGNOSTIC PROCEDURES (INTERPRETATION ONLY) |
||
| 04720 | Wax-up, Diagnostic (To Evaluate Cosmetic And/Or Preparation Design And/Or Occlusal |
||
| 04729 | Each additional unit over four |
$77.9
+Lab Costs |
$77.9
+Lab Costs |