| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
286 |
281 |
$38K |
| 71250 |
|
81 |
81 |
$4K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
15 |
15 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
70 |
66 |
$490.71 |
| 71045 |
Radiologic examination, chest; single view |
272 |
228 |
$466.64 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
136 |
89 |
$75.83 |