| Name | Value |
|---|---|
| NAME | TOMOGRAM COMPLEX MOTION BILAT |
| PACKAGE NAME | TOMOGRAM COMPLEX MOTION BILAT |
| ID | 440;99RAP |
| CODE | 76102 |
| CODING SYSTEM | CPT4 |
| DISPLAY GROUP | IMAGING |
| AUTHORIZATION | PHYSICIAN |
| PROCEDURE TYPE | DETAILED |
| IMAGING TYPE | RADIOLOGY |
| COMMON PROCEDURE | NO |
| SET MEMBERSHIP |
|