| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
636 |
635 |
$17K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
125 |
83 |
$16K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
148 |
110 |
$10K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
60 |
37 |
$9K |
| 76770 |
|
108 |
108 |
$4K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
87 |
86 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
95 |
95 |
$734.61 |