| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,079 |
848 |
$87K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,896 |
1,467 |
$86K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
145 |
108 |
$6K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
24 |
15 |
$3K |
| 72141 |
|
39 |
36 |
$2K |
| 82565 |
|
424 |
323 |
$566.31 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
22 |
13 |
$300.00 |
| 99072 |
|
236 |
211 |
$219.15 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
298 |
253 |
$209.71 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
292 |
233 |
$10.78 |
| A9573 |
Injection, gadopiclenol, 1 ml |
205 |
154 |
$0.00 |