| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
117 |
101 |
$34K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
260 |
243 |
$12K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
40 |
25 |
$6K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
18 |
17 |
$5K |
| 71046 |
Radiologic examination, chest; 2 views |
315 |
291 |
$4K |
| 73221 |
|
16 |
12 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
73 |
66 |
$2K |
| 72110 |
|
72 |
62 |
$1K |
| 73030 |
|
32 |
25 |
$439.29 |
| 72100 |
|
12 |
12 |
$220.00 |
| 72040 |
|
12 |
12 |
$173.36 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
16 |
13 |
$22.40 |