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Abdomen
Brain
Breast R L
Chest
Extremity Upper Lower
Site: R L
Joint Upper Lower
Site: R L
MR Arthrogram
Site:
Neck
Orbits/Face/Neck/(IAC/Pit)
Pelvis
Spine - Cervical
Spine - Lumbar
Spine - Thoracic
TMJ
MRA
MRA Abdomen
MRA Chest
MRACP Cholangiogram
MRA Head
MRA Neck/Carotid
MRA Pelvis
MRA Renal
MRA Thoracic
MRA Upper Ext
MRA Lower Ext
Nuclear Medicine
Bone Scan - 3 Phase
Bone Scan - Limited Area
Bone Scan - Whole Body
Gastric Emptying Study
HIDA Scan
HIDA Scan w/ Ejection Fraction
Liver and Spleen Scan
Liver Scan
MUGA Scan w/ Ejection
Parathyroid Sestamibi Imaging
Scintimammography/Miraluma Breast Scan
Spleen Scan Only
Testicular Scan Flow
Testicular Scan w/ Iodine
Thyroid Scan w/ Iodine
Thyroid Scan w/ Tc99
Thyroid Uptake and Scan w/ Iodine
Triple Renal Scan w/ Lasix
Triple Renal Scan w/o Lasix
Triple Renal Scan w/ Captopri
PET
PET w/CT Fusion
PET w/MRI Fusion
Limited
Skull to Mid-Thigh
Whole Body (Melanoma)
Brain
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Abdomen
Abdomen & Pelvis
Abdomen & Pelvis (Renal Stone)
Chest
Extremity Upper Lower
Site: R L
Facial Bones
Head
IAC / Temporal Bones
Joint Upper Lower
Site: R L
Myelogram
Site:
Neck, Soft Tissue
Orbits
Pelvis
Sinus Limited Complete
Spine - Cervical
Spine - Lumbar
Spine - Thoracic
Urogram (CT IVP)
Virtual Colonoscopy
Other:
CTA w/3D
AAA Protocol
Aorto-Iliofemoral Runof
Abdominal Aorta / Renal / Mesenteric
Chest
Head
Neck/Carotid
Pelvis
Upper / Lower Extremity
Site:
Bone Density
Dexa
Fluoroscopy
Barium Enema (Single Contrast)
Barium Enema w/ Air
Barium Swallow / Esophogram
Fistulogram
Loopogram
Small Bowel Series
Upper GI
Upper GI w/ Small Bowel
Venogram Upper Lower
Site:
Cystogram (Static)
Cystogram (Voiding)
Adenosine Dual
Isotope Stress Test
Digital Mammography
Screening R L Bil
Diagnostic R L Bil
Hookwire Loc R L
Ductogram R L
Other:
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Ultrasound/Sono
Abdomen Complete
Abdomen Limited
Aspiration
Site
Breast R L
Breast Cyst Aspiration
Bypass Graft R L
Chest
Extremity Lower - Site
R L
Extremity Upper - Site
R L
Hook Wire Localization
Breast R L
Renal (Kidney) / Aorta
Neck Soft Tissue
OB 1st Trimester < 13 wks
OB 2nd or 3rd Trimester
Pelvis Transabdominal and Transvaginal
Testicles / Scrotum
Thyroid
Other:
Doppler
Doppler Arterial Lower Ext
w/ ABI R L
Doppler Arterial Upper Ext
w/ ABI R L
Doppler Venous Lower Ext / DVT
R L
Doppler Venous Up Ext / DVT
R L
Doppler Abdomen
Doppler Carotid
Doppler Renal Arterial
Other:
Procedures
Arthrogram - Site
Catheter Patency
CT - Guided Aspiration
Site
CT - Guided Biopsy
Site
Hysterosalpingogram (HSG)
Lumbar Puncture
Diagnostic Therapeutic
Myelogram - Site
Paracentesis
PICC Line Placement
Sonohysterogram
Thoracentesis
Ultrasound Guided Aspiration
Site
Ultrasound Guided Biopsy
Site
Steroid Injection
Site
ESI - Site
Facet - Site
Lymphoscintigraphy
Site
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X-ray
Abdomen KUB
Abdomen Series w/ Chest
Abdominal Flat
Abdominal Upright
AC Joints w/ Weights
AC Joints w/o Weights
Bone Age Study
Chest PA
Chest PA / Lat
Clavicle R L
Extremity Lower - Site
R L
Extremity Upper - Site
R L
Facial Complete
Facial Partial
Heel / Calcaneous
Hip w/ Pelvis R L
Neck Soft Tissue
Pelvis
Ribs R L
Sacroiliac Joint R L
Sacrum / Coccyx
Scoliosis Study
Shoulder R L
Sinus Complete 3V
Sinus Partial
Skeletal Survey
Spine - C 3V/5V/7V
Spine - L 3V/5V/7V
Spine - T 3V/5V/7V
Thoracolumbar AP LA
Additional Comments
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