| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
390 |
390 |
$29K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
39 |
39 |
$7K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
99 |
83 |
$6K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
92 |
89 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
528 |
528 |
$5K |
| 71250 |
|
155 |
155 |
$4K |
| 99072 |
|
152 |
146 |
$2K |
| 70498 |
|
13 |
13 |
$2K |
| 70496 |
|
12 |
12 |
$2K |
| 74178 |
|
12 |
12 |
$1K |
| 72141 |
|
12 |
12 |
$359.87 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
69 |
69 |
$276.32 |
| 71045 |
Radiologic examination, chest; single view |
29 |
29 |
$206.70 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
30 |
30 |
$36.63 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
40 |
40 |
$3.87 |
| G9329 |
Dicom format image data available to non-affiliated external healthcare facilities or entities on a secure, media free, reciprocally searchable basis with patient authorization for at least a 12-month period after the study not documented in final report, reason not given |
82 |
70 |
$0.00 |