Referring MD name-ENTER_1
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L/R sacroiliac joint-SELECT_2
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pre-procedure diagnosis-ENTER_3
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L or R sacroiliac joint-SELECT_4
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? cc of 1% buffer lidocaine-SELECT_5
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? cc of Omnipaque_6
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L/R sacro-iliac joint_7
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Arthrogram_8
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L/R sacro-iliac joint_9
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Post procedure pain_10
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Pre-procedure pain level_11
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