| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
7,311 |
6,672 |
$267K |
| 70450 |
Computed tomography, head or brain; without contrast material |
8,501 |
7,917 |
$129K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
3,721 |
3,581 |
$88K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
2,250 |
2,107 |
$75K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,142 |
965 |
$69K |
| 76641 |
|
3,452 |
1,971 |
$66K |
| 71045 |
Radiologic examination, chest; single view |
20,897 |
16,118 |
$62K |
| 71046 |
Radiologic examination, chest; 2 views |
10,904 |
10,085 |
$51K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
3,007 |
2,887 |
$50K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,108 |
868 |
$41K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
806 |
677 |
$28K |
| 71250 |
|
588 |
489 |
$12K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
759 |
704 |
$10K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
286 |
246 |
$9K |
| 76642 |
|
535 |
434 |
$9K |
| 76770 |
|
595 |
537 |
$8K |
| 72141 |
|
183 |
149 |
$7K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
239 |
220 |
$5K |
| 93971 |
|
218 |
181 |
$3K |
| 77080 |
|
208 |
146 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
188 |
171 |
$3K |
| 77065 |
Tomosynthesis, mammo |
182 |
141 |
$3K |
| 76376 |
|
497 |
441 |
$2K |
| 74183 |
|
30 |
25 |
$2K |
| 77066 |
Tomosynthesis, mammo |
80 |
68 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
80 |
76 |
$1K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
41 |
24 |
$1K |
| 93976 |
|
28 |
28 |
$1K |
| 73610 |
|
269 |
247 |
$1K |
| 73630 |
|
264 |
225 |
$951.52 |
| 73030 |
|
174 |
159 |
$688.86 |
| 77089 |
|
188 |
132 |
$590.52 |
| 76830 |
Ultrasound, transvaginal |
28 |
27 |
$505.50 |
| 73564 |
|
56 |
52 |
$260.00 |
| 77062 |
|
13 |
13 |
$222.00 |
| 72110 |
|
28 |
27 |
$217.92 |
| 74018 |
|
61 |
41 |
$187.44 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
457 |
305 |
$177.11 |
| 77061 |
|
12 |
12 |
$166.50 |
| 73130 |
|
39 |
35 |
$163.84 |
| 72100 |
|
30 |
27 |
$143.00 |
| 76536 |
|
16 |
13 |
$128.32 |
| 73562 |
|
33 |
24 |
$106.80 |
| 73110 |
|
14 |
13 |
$61.44 |
| 73502 |
|
16 |
12 |
$55.76 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
15 |
12 |
$41.02 |