Designed the P+ QA Test Phantom for testing medical diagnostic x-ray systems. P+ QA Test Phantom is a water equivalent to standard 23 cm AP L/S spine radiographic image with medical diagnostic x-ray system. Standard radiographic technique factors such as kvP, mAs are found in a National database called NEXT National Evaluation of X-ray Trends. The user may compare their x-ray system radiation dose and quality image to the database and verify radiation dose is below the national average of the U.S. database. Users may also use P+ QA Test Phantom to improve image quality and EI values in digital imaging.