02111 Single image
| 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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| 02110 | Radiographs, Periapical |
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| 02111 | Single image | $28.81 | $28.81 |