Ultrasound Order

Please complete the form below

Your Name (Don't forget your credentials for report purposes)*

Your Expectant Mama's Name (as it appears on her insurance card)



Standard Ultrasound less than 14 weeks gestation - with rad report/signed. (Recommended between 8-10 weeks)


NT Nuchal Translucency measurement


2nd Trimester | 76805

Detailed Anatomy Scan ultrasound, pregnant uterus, real time with image documentation, maternal evaluation plus detailed fetal anatomic examination, transabdominal, single or first gestation.

(Recommended between 18-22 weeks)


76815 Limited Ultrasound

(Quick look- evaluates fetal heartbeat, placental location, fetal position and/or qualitative amniotic fluid volume)- with rad report/signed


76819 Fetal Biophysical Profile without non-stress testing

(Recommended between 36-42 weeks)


76816 Follow up Ultrasound

(re-evaluation of fetal size, organ systems, or previous abnormality seen on other scan)

 76856 Pelvic Ultrasound

(pelvic measurements, endometrium, ovaries)


OB Diagnostic exams on Tuesdays

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