| CPT |
Description |
Number of Claims |
Sum Performed |
|
Q3014
|
TELEHEALTH FACILITY FEE |
2
|
2
|
|
78306
|
BONE IMAGING WHOLE BODY |
2
|
2
|
|
A9503
|
TC99M MEDRONATE |
2
|
2
|
|
G0463
|
HOSPITAL OUTPT CLINIC VISIT |
2
|
2
|
|
72158
|
MRI LUMBAR SPINE W/O & W/DYE |
2
|
2
|
|
Q9969
|
NON-HEU TC-99M ADD-ON/DOSE |
1
|
1
|
|
99213
|
OFFICE O/P EST LOW 20 MIN |
1
|
1
|
|
G0467
|
FQHC VISIT, ESTAB PT |
1
|
1
|
|
70553
|
MRI BRAIN STEM W/O & W/DYE |
1
|
1
|
|
A9577
|
INJ MULTIHANCE |
1
|
18
|
|
72110
|
X-RAY EXAM L-2 SPINE 4/>VWS |
1
|
1
|
|
72131
|
CT LUMBAR SPINE W/O DYE |
1
|
1
|
|
G1004
|
CDSM NDSC |
1
|
1
|
|
78803
|
RP LOCLZJ TUM SPECT 1 AREA |
1
|
1
|
|
74177
|
CT ABD & PELVIS W/CONTRAST |
1
|
1
|
|
Q9963
|
HOCM 350-399MG/ML IODINE,1ML |
1
|
120
|
|
Q9967
|
LOCM 300-399MG/ML IODINE,1ML |
1
|
100
|
|
A9575
|
INJ GADOTERATE MEGLUMI 0.1ML |
1
|
200
|
|
A9585
|
GADOBUTROL INJECTION |
1
|
84
|
|
20225
|
BONE BIOPSY TROCAR/NDL DEEP |
1
|
1
|
