| Code | Description | Claims | Beneficiaries | Total Paid |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
239 |
170 |
$21K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
404 |
344 |
$12K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
552 |
552 |
$11K |
| 72141 |
|
248 |
206 |
$9K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
220 |
220 |
$5K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
92 |
66 |
$5K |
| 74178 |
|
87 |
87 |
$4K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
56 |
40 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
185 |
185 |
$3K |
| 76830 |
Ultrasound, transvaginal |
178 |
177 |
$3K |
| 76641 |
|
101 |
81 |
$2K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
332 |
321 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
28 |
28 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
60 |
55 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
315 |
312 |
$2K |
| 70486 |
|
43 |
43 |
$2K |
| 76536 |
|
113 |
108 |
$1K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
20 |
19 |
$1K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
21 |
21 |
$1K |
| 76770 |
|
54 |
54 |
$1K |
| 77080 |
|
241 |
241 |
$1K |
| 72131 |
|
16 |
16 |
$950.00 |
| 71250 |
|
27 |
27 |
$707.34 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
282 |
280 |
$685.10 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
14 |
13 |
$612.80 |
| 71045 |
Radiologic examination, chest; single view |
55 |
39 |
$329.59 |
| 72110 |
|
13 |
13 |
$324.31 |
| 76376 |
|
1,477 |
1,429 |
$178.45 |
| 73630 |
|
12 |
12 |
$89.09 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
30 |
30 |
$1.20 |