| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
2,215 |
2,174 |
$62K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
1,023 |
1,015 |
$36K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
70 |
70 |
$3K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
38 |
38 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
663 |
638 |
$2K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$205.22 |