81142 Appliance, Mandibular, Simple
| 80000 | ORTHODONTICS |
||
| 81000 | APPLIANCES, ACTIVE, FOR TOOTH GUIDANCE OR MINOR TOOTH MOVEMENT |
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| 81100 | APPLIANCES, REMOVABLE |
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| 81140 | Appliances, Removable, Closure of Diastemas |
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| 81142 | Appliance, Mandibular, Simple |
$349.31
+Lab Costs |
$349.31
+Lab Costs |