| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71250 |
|
61 |
54 |
$0.00 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
17 |
14 |
$0.00 |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
18 |
16 |
$0.00 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
21 |
19 |
$0.00 |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
13 |
12 |
$0.00 |
| 72141 |
|
36 |
33 |
$0.00 |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
48 |
40 |
$0.00 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
18 |
17 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13 |
12 |
$0.00 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
107 |
99 |
$0.00 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
13 |
12 |
$0.00 |
| 74183 |
|
14 |
13 |
$0.00 |