22500 RESTORATIONS PREFABRICATED, PLASTIC, PERMANENT TEETH
| 20000 | RESTORATION |
||
| 22000 | RESTORATIONS, PREFABRICATED, FULL COVERAGE |
||
| 22500 | RESTORATIONS PREFABRICATED, PLASTIC, PERMANENT TEETH | ||
| 22501 | Permanent Anterior |
243.29 | 243.29 |
| 22511 | Permanent Posterior |
243.29 | 243.29 |