| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
2,614 |
2,403 |
$160K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
771 |
729 |
$61K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
212 |
199 |
$14K |
| 70491 |
|
118 |
108 |
$5K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
140 |
130 |
$4K |
| 70496 |
|
28 |
28 |
$3K |
| 72110 |
|
155 |
151 |
$2K |
| 70498 |
|
12 |
12 |
$1K |
| 70486 |
|
33 |
27 |
$1K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
12 |
12 |
$8.79 |