14912 Two units
| 10000 | PREVENTION |
||
| 14000 | APPLIANCES |
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| 14900 | APPLIANCES, INTRAORAL, TO TREAT MEDICALLY DIAGNOSED OBSTRUCTIVE SLEEP APNEA, |
||
| 14910 | Appliance, Intraoral, For the Treatment of Obstructive Airway Disorders, Periodic Maintenance, |
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| 14912 | Two units |
$171.35
+Lab Costs |
$171.35
+Lab Costs |