| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
151 |
151 |
$48K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
96 |
94 |
$29K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
157 |
154 |
$10K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
18 |
17 |
$10K |
| 70450 |
Computed tomography, head or brain; without contrast material |
125 |
117 |
$4K |
| 72100 |
|
163 |
158 |
$4K |
| 72141 |
|
14 |
14 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
223 |
218 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
239 |
219 |
$1K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
47 |
20 |
$724.50 |