41232 Two units
| 40000 | PERIODONTICS |
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| 41000 | PERIODONTAL SERVICES, NON SURGICAL |
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| 41200 | ORAL DISEASE, Management of |
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| 41230 | Oral Manifestations of Systemic Disease or complications of medical therapy e.g. complications of |
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| 41232 | Two units | $166.84 | $166.84 |