Alegent Health Northwest Imaging Center Llc

Omaha, Independent Diagnostic Testing Facility

Received $55,289 from Medicare for services in 2012

2012 reimbursement details

Service Times performed Avg. Medicare payment Total payments
Mri lumbar spine w/o dye 51 $235 $11,997
Mri jnt of lwr extre w/o dye 30 $231 $6,934
Ct abd & pelv w/contrast 35 $189 $6,628
Mri neck spine w/o dye 25 $221 $5,513
Mri joint upr extrem w/o dye 22 $240 $5,275
Mri brain w/o dye 20 $235 $4,701
Ct thorax w/dye 20 $159 $3,187
Ct thorax w/o dye 17 $119 $2,021
Us exam abdom complete 23 $67 $1,536
Ct lower extremity w/o dye 12 $127 $1,521
Extracranial study 14 $103 $1,440
Ct head/brain w/o dye 14 $102 $1,432
Extremity study 19 $70 $1,320
Us exam abdo back wall lim 17 $57 $963
LOCM 300-399mg/ml iodine,1ml 5,640 $0 $614
X-ray exam of lower spine 11 $19 $207

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