| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
3,935 |
3,632 |
$239K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,158 |
1,086 |
$109K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
693 |
665 |
$57K |
| 72110 |
|
1,014 |
962 |
$15K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
285 |
271 |
$9K |
| 70491 |
|
136 |
118 |
$6K |
| 70486 |
|
106 |
98 |
$3K |
| 72050 |
|
115 |
111 |
$2K |
| 70496 |
|
14 |
14 |
$992.95 |
| 70498 |
|
12 |
12 |
$961.57 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$852.04 |
| 72100 |
|
55 |
50 |
$720.99 |
| 72040 |
|
57 |
45 |
$567.05 |
| 72072 |
|
28 |
26 |
$269.79 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
48 |
48 |
$77.14 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
12 |
12 |
$52.71 |