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Exams Requested  MRI MRA (MR Angiography including 3-D Reconstruction) X-Ray Ultrasound Contrast No Contrast

Body Part(s) to be examined

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CT Screening  Calcium Score

CT Scans  Brain Orbits Inner / Middle / Outer Ear Maxillofacial Sinus Maxillofacial Dental Neck / Soft Tissue Chest Abdomen Pelvis CT Urography Cervical Spine Thoracic Spine Lumbar Spine Upper Extremity Lower Extremity

With IV Contrast Yes or No... Yes No

 

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