52921 Maxillary
| 50000 | PROSTHODONTICS - REMOVABLE |
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| 52000 | DENTURES, PARTIAL, ACRYLIC |
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| 52900 | DENTURES, PARTIAL, OVERDENTURES, ACRYLIC, WITH CAST/WROUGHT CLASPS AND/OR RESTS |
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| 52920 | Dentures, Partial, Overdentures, Acrylic, with Cast/Wrought Clasps and/or Rests, with Independent |
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| 52921 | Maxillary |
$1003.76
+Lab Costs |
$1003.76
+Lab Costs |