| Code | Description | Claims | Beneficiaries | Total Paid |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,528 |
1,393 |
$112K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
918 |
848 |
$107K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
572 |
403 |
$68K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
430 |
367 |
$44K |
| 37187 |
|
53 |
31 |
$39K |
| 19083 |
|
105 |
93 |
$36K |
| 72141 |
|
333 |
301 |
$35K |
| 71046 |
Radiologic examination, chest; 2 views |
1,782 |
1,606 |
$30K |
| 73221 |
|
178 |
156 |
$23K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
114 |
92 |
$18K |
| 76642 |
|
386 |
311 |
$18K |
| 77066 |
Tomosynthesis, mammo |
175 |
165 |
$18K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
249 |
232 |
$16K |
| J2997 |
Injection, alteplase recombinant, 1 mg |
90 |
63 |
$15K |
| 76942 |
|
255 |
209 |
$10K |
| 36012 |
|
51 |
29 |
$8K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
15 |
14 |
$7K |
| 93971 |
|
109 |
97 |
$6K |
| 99152 |
|
228 |
181 |
$6K |
| 99153 |
Mod sedat endo service >5yrs |
378 |
201 |
$6K |
| 19081 |
|
14 |
13 |
$5K |
| 73030 |
|
306 |
237 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
84 |
69 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
644 |
550 |
$4K |
| 73562 |
|
227 |
167 |
$4K |
| 76641 |
|
57 |
44 |
$3K |
| 76377 |
|
179 |
153 |
$3K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
268 |
206 |
$3K |
| 93976 |
|
48 |
31 |
$3K |
| 76830 |
Ultrasound, transvaginal |
65 |
50 |
$3K |
| 72100 |
|
149 |
132 |
$3K |
| 76536 |
|
39 |
34 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
280 |
209 |
$2K |
| 77065 |
Tomosynthesis, mammo |
34 |
24 |
$2K |
| 75820 |
|
47 |
31 |
$2K |
| 73630 |
|
88 |
66 |
$1K |
| 77080 |
|
63 |
59 |
$1K |
| 10022 |
|
16 |
14 |
$1K |
| 74018 |
|
47 |
45 |
$782.07 |
| 60100 |
|
17 |
12 |
$781.52 |
| 76770 |
|
14 |
12 |
$772.52 |
| 72110 |
|
30 |
27 |
$703.08 |
| 76937 |
|
46 |
27 |
$581.82 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
17 |
15 |
$530.12 |
| 72072 |
|
27 |
24 |
$491.33 |
| 73130 |
|
15 |
12 |
$297.91 |
| 72040 |
|
12 |
12 |
$268.02 |
| 73080 |
|
15 |
14 |
$246.35 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
238 |
189 |
$132.09 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
222 |
181 |
$59.49 |
| G0202 |
Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed |
32 |
27 |
$0.00 |