William A. Ricker - Page 5




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          radiographic picture.  The panoramic x-ray is used primarily as a           
          preliminary diagnostic technique, focusing attention on areas               
          that may pose increased concern.  The cost of the radiograph that           
          the machine produces is cheaper than a “full-mouth” series                  
          produced by a standard dental x-ray machine.                                
               At the time that he acquired the panoramic x-ray machine,              
          petitioner had the option of purchasing, as an accessory at an              
          additional cost, a patient chair that could be affixed to the               
          base of the machine.  Petitioner opted against purchasing the               
          patient chair.  Without the chair, patients customarily stand               
          while holding handles to maintain stillness and “bite on a little           
          piece to position their head”, whereas patients who are confined            
          to a wheelchair are instructed to do the same while remaining               
          seated in their wheelchair, which is rolled directly under the              
          machine over a flat base.  Thus, by opting not to purchase the              
          accessory chair, petitioner reduced the acquisition cost of the             
          panoramic x-ray machine and avoided the risk inherent in                    
          transferring a disabled patient from chair to chair, but without            
          compromising the diagnostic value of the x-ray machine to able-             
          bodied patients.                                                            
               Petitioner uses the panoramic x-ray machine on a daily basis           
          and for all of his patients without regard to whether an                    
          individual is disabled or able-bodied.  Indeed, the machine is              
          intended to improve the standard of care for all patients and was           






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