| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
211 |
208 |
$22K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
120 |
112 |
$15K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
154 |
145 |
$3K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
12 |
12 |
$3K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
40 |
40 |
$2K |
| 76830 |
Ultrasound, transvaginal |
26 |
26 |
$2K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
12 |
12 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
68 |
68 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
112 |
98 |
$628.95 |
| 72110 |
|
13 |
13 |
$385.58 |