02133 Three images
| 00000 | DIAGNOSTIC |
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| 02000 | RADIOGRAPHS (including radiographic examination and diagnosis and interpretation) |
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| 02100 | RADIOGRAPHS, REGIONAL/LOCALIZED |
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| 02130 | Radiographs, Occlusal |
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| 02133 | Three images | $93.34 | $93.34 |