22200 RESTORATIONS, PREFABRICATED, METAL, PRIMARY TEETH
| 20000 | RESTORATION |
||
| 22000 | RESTORATIONS, PREFABRICATED, FULL COVERAGE |
||
| 22200 | RESTORATIONS, PREFABRICATED, METAL, PRIMARY TEETH | ||
| 22201 | Primary Anterior |
216.37 | 216.37 |
| 22202 | Primary Anterior - open face/acrylic veneer |
266.67
+Lab Costs |
266.67
+Lab Costs |
| 22211 | Primary Posterior |
211.89 | 211.89 |
| 22212 | Primary Posterior - open face |
286.25 | 286.25 |