6 without Contrast Chest with Contrast 7 Chest with Contrast 8 (Non- Ionic) Abdomen without 9 Contrast Abdomen with 10 Contrast Abdomen with 11 Contrast (Non- Ionic) & Abdomen 12 without Contrast Chest & Abdomen 13 with Contrast ( Ionic) Chest & Abdomen 14 with Contrast ( Non- Ionic) 15 Pelvis Pelvis with Contrast 16 (Ionic) Pelvis with Contrast 17 (Non- Ionic) Abdomen & Pelvis 18 without Contrast Abdomen & Pelvis 19 with Contrast Abdomen & Pelvis 20 with Contrast (Non- Ionic) ( One Disc 21 Space) ( Each Additional 22 Disc Space)
6 without Contrast 7 Chest with Contrast 8 Chest with Contrast (Non- Ionic) 9 Abdomen without Contrast 10 Abdomen with Contrast 11 Abdomen with Contrast (Non- Ionic) 12 & Abdomen without Contrast 13 Chest & Abdomen with Contrast ( Ionic) 14 Chest & Abdomen with Contrast ( Non- Ionic) 15 Pelvis 16 Pelvis with Contrast (Ionic) 17 Pelvis with Contrast (Non- Ionic) 18 Abdomen & Pelvis without Contrast 19 Abdomen & Pelvis with Contrast 20 Abdomen & Pelvis with Contrast (Non- Ionic) 21 ( One Disc Space) 22 ( Each Additional Disc Space)
Appendices-for-therapy-services-to-Jordan-August-20151.docx