| Code | Description | Claims | Beneficiaries | Total Paid |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
4,886 |
4,803 |
$620K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
4,801 |
4,724 |
$242K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
533 |
508 |
$101K |
| 77066 |
Tomosynthesis, mammo |
550 |
536 |
$78K |
| 76642 |
|
1,083 |
899 |
$75K |
| 76830 |
Ultrasound, transvaginal |
606 |
596 |
$60K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
608 |
603 |
$56K |
| 73221 |
|
224 |
217 |
$41K |
| 77065 |
Tomosynthesis, mammo |
328 |
309 |
$35K |
| 71046 |
Radiologic examination, chest; 2 views |
1,180 |
1,158 |
$30K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
182 |
179 |
$26K |
| 76641 |
|
265 |
168 |
$25K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
238 |
236 |
$24K |
| 77062 |
|
222 |
216 |
$21K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
64 |
55 |
$19K |
| 73630 |
|
365 |
334 |
$10K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
383 |
377 |
$8K |
| 77080 |
|
179 |
174 |
$5K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
215 |
208 |
$4K |
| 72141 |
|
12 |
12 |
$3K |
| 73562 |
|
46 |
39 |
$2K |
| 72100 |
|
38 |
38 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
12 |
12 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$1K |
| 76536 |
|
13 |
12 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
17 |
17 |
$1K |
| 77089 |
|
50 |
49 |
$1K |
| 73610 |
|
40 |
39 |
$985.51 |
| 73130 |
|
29 |
24 |
$772.14 |
| 77061 |
|
13 |
13 |
$507.18 |
| 72110 |
|
12 |
12 |
$486.22 |
| 76882 |
|
13 |
12 |
$316.16 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
64 |
62 |
$314.95 |
| S9999 |
Sales tax |
12 |
12 |
$74.89 |
| J3490 |
Unclassified drugs |
24 |
13 |
$3.37 |