| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
177 |
176 |
$150K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
188 |
186 |
$70K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
102 |
102 |
$39K |
| 74183 |
|
24 |
24 |
$18K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
979 |
694 |
$18K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
13 |
13 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
133 |
133 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
97 |
79 |
$1K |