| 1418 | Prosthesis, Orthodontic |
| 1418 | Prosthesis, Orthodontic |
| 06970617030100 | Prosthesis, Orthodontic |
| 06970617030094 | Prosthesis, Orthodontic |
| 06970617030087 | Prosthesis, Orthodontic |
| 06970617030025 | Prosthesis, Orthodontic |
| 06972677870078 | Prosthesis, Orthodontic |
| 06977512700039 | Prosthesis, Orthodontic |
| LVI GLOBAL "FIXED" ORTHOTIC | UNK | 2019-11-18 |
| ORTHODONTIC SPRING RETAINER | UNK | 2018-07-17 |
| MD SPRING | UNK | 2018-07-17 |