| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
3,959 |
3,545 |
$239K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,191 |
1,091 |
$116K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
539 |
513 |
$41K |
| 70496 |
|
99 |
97 |
$9K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
278 |
252 |
$8K |
| 70486 |
|
114 |
96 |
$4K |
| 70491 |
|
89 |
82 |
$4K |
| 70498 |
|
42 |
40 |
$4K |
| 72110 |
|
160 |
156 |
$2K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$679.54 |
| 70544 |
|
13 |
12 |
$373.98 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
30 |
28 |
$54.62 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
14 |
14 |
$8.14 |