41219 Each additional unit over four
| 40000 | PERIODONTICS |
||
| 41000 | PERIODONTAL SERVICES, NON SURGICAL |
||
| 41200 | ORAL DISEASE, Management of |
||
| 41210 | Oral Manifestations, Oral Mucosal Disorders, Mucocutaneous disorders and diseases of localized |
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| 41219 | Each additional unit over four | $83.42 | $83.42 |