| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
38 |
25 |
$8K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
30 |
27 |
$5K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
32 |
29 |
$4K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
14 |
13 |
$3K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
129 |
53 |
$0.86 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
64 |
45 |
$0.00 |