GQE-120717-5895d7e7a1

7 Dec 2017
# Item Codes and Description Quantity Price
1 Abscess Drainage
  • d-013: Oral examination – limited
  • d-022: Intraoral periapical or bitweing radiograph – per exposure
  • d-037: Panoramic radiograph – per exposure
  • d-392: Drainage of abscess
1x(259.90)
  • 1x(27.95)
  • 1x(37.65)
  • 1x(95.80)
  • 1x(98.50)
259.90
2 d-011
  • d-011: Comprehensive oral examination
1x(53.55)
  • 1x(53.55)
53.55
Sub Total (A): 313.45
Cover Payout (D): 288.07
Gap Total (Est.): (C – D) 25.38

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