| A | B |
|---|
| 74177 | CT ABD and Pelv W/ Contrast |
| 70551 | MRI Brain W/O Contrast |
| 70450 | CT Head/Brain W/O Contrast |
| 72196 | MRI Pelvis W/ Contrast |
| 78452 | Nuclear Stress Test |
| 93306 | Echo Complete W/ Doppler |
| 70491 | CT Soft Tissue Neck W/ Contrast |
| 72158 | MRI L Spine W/ and W/O Contrast |
| 72141 | MRI Cervical Spine W/O Contrast |
| 74183 | MRI Abdomen W/ and W/O Contrast |
| 70481 | CT Orbit W/ Contrast |
| 70488 | CT Maxllfcl W/ and W/O Contrast |
| 70548 | MRA Neck W/ Contrast |
| 70496 | CTA Head |
| 70498 | CTA Neck |
| 71551 | MRI Chest W/ Contrast |
| 70336 | MRI TMJ |
| 78227 | HIDA Scan |
| 78306 | Bone Scan Whole Body |
| 78815 | PET W/ CT Skull to Mid-Thigh |
| 33225 | L Ventric Pacing Lead Add-On |
| RCPROS | Prostate Adenocarcinoma |
| MSMPT | Physical Therapy |
| 95800 | Sleep Study, Unattended |
| 93458 | L Cath, Ventriculography NV |
| 78812 | PET Skull Base to Mid-Thigh |
| 78472 | Cardiac BloodPool Imaging, Single |
| 77059 | MRI Breas Bilateral |
| 76816 | U/S OB Pelvis Follow Up or Rep |
| 74174 | CT Angio Abd and Pelv W/ and W/O Contrast |
| 74150 | CT Abdomen W/O Contrast |
| 73721 | MRI Lower Extremity Joint W/O Contrast |
| 73221 | MRI Upper Extremity Joint W/O Contrast |
| 73718 | MRI Lower Extremity W/O Contrast |
| 73218 | MRI Upper Extremity W/O Contrast |
| 72157 | MRI T Spine W/ W/O Contrast |
| 72125 | CT C Spine W/O Contrast |
| 72131 | CT L Spine W/O Contrast |
| 72128 | CT T Spine W/O Contrast |
| 71275 | CTA Chest |
| 71260 | CT Thorax W/ Contrast |
| 70540 | MRI Face, Orbit, Neck W/O Contrast |
| 64484 | Transforam Epidural inj addl |
| 64483 | Epidural inj; single level |
| 72191 | CTA Pelvis |
