| CPT |
Description |
Number of Claims |
Sum Performed |
|
A9270
|
NON-COVERED ITEM OR SERVICE |
13
|
22
|
|
72148
|
MRI LUMBAR SPINE W/O DYE |
10
|
10
|
|
G0463
|
HOSPITAL OUTPT CLINIC VISIT |
3
|
3
|
|
80048
|
METABOLIC PANEL TOTAL CA |
3
|
3
|
|
72158
|
MRI LUMBAR SPINE W/O & W/DYE |
3
|
3
|
|
96372
|
THER/PROPH/DIAG INJ SC/IM |
2
|
3
|
|
73721
|
MRI JNT OF LWR EXTRE W/O DYE |
2
|
2
|
|
85027
|
COMPLETE CBC AUTOMATED |
2
|
2
|
|
A9575
|
INJ GADOTERATE MEGLUMI 0.1ML |
2
|
400
|
|
97161
|
PT EVAL LOW COMPLEX 20 MIN |
2
|
2
|
|
J3490
|
DRUGS UNCLASSIFIED INJECTION |
2
|
3
|
|
62380
|
NDSC DCMPRN 1 NTRSPC LUMBAR |
1
|
1
|
|
72100
|
X-RAY EXAM L-S SPINE 2/3 VWS |
1
|
1
|
|
71046
|
X-RAY EXAM CHEST 2 VIEWS |
1
|
1
|
|
80053
|
COMPREHEN METABOLIC PANEL |
1
|
1
|
|
84703
|
CHORIONIC GONADOTROPIN ASSAY |
1
|
1
|
|
86850
|
RBC ANTIBODY SCREEN |
1
|
1
|
|
86900
|
BLOOD TYPING SEROLOGIC ABO |
1
|
1
|
|
86901
|
BLOOD TYPING SEROLOGIC RH(D) |
1
|
1
|
|
93005
|
ELECTROCARDIOGRAM TRACING |
1
|
1
|
