| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
4,070 |
3,582 |
$248K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,105 |
1,049 |
$100K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
623 |
595 |
$48K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
215 |
204 |
$7K |
| 70491 |
|
137 |
124 |
$6K |
| 72110 |
|
299 |
291 |
$5K |
| 70486 |
|
103 |
96 |
$3K |
| 70496 |
|
25 |
24 |
$3K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
14 |
14 |
$2K |
| 70480 |
|
12 |
12 |
$583.57 |
| 70544 |
|
13 |
13 |
$408.16 |
| 72100 |
|
29 |
27 |
$306.96 |
| 72040 |
|
12 |
12 |
$97.28 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
29 |
28 |
$40.59 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
14 |
14 |
$29.40 |