| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 78815 |
Positron emission tomography (PET) for limited area imaging |
345 |
295 |
$347K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
558 |
516 |
$109K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
214 |
194 |
$80K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
238 |
211 |
$63K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
172 |
163 |
$41K |
| 72141 |
|
80 |
75 |
$18K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
496 |
410 |
$14K |
| 73221 |
|
42 |
38 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
177 |
152 |
$10K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
1,059 |
909 |
$4K |
| 74018 |
|
29 |
25 |
$2K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
46 |
38 |
$344.76 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
47 |
29 |
$155.63 |