| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71250 |
|
2,170 |
2,159 |
$102K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,437 |
1,429 |
$95K |
| 93976 |
|
1,929 |
1,881 |
$81K |
| 76641 |
|
6,290 |
4,307 |
$78K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
961 |
865 |
$71K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,419 |
5,416 |
$65K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
729 |
719 |
$51K |
| 76376 |
|
5,110 |
4,772 |
$33K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,775 |
1,749 |
$26K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
21,479 |
19,630 |
$21K |
| 76536 |
|
1,785 |
1,766 |
$19K |
| 77065 |
Tomosynthesis, mammo |
1,517 |
1,503 |
$17K |
| 74183 |
|
115 |
114 |
$16K |
| 71046 |
Radiologic examination, chest; 2 views |
2,718 |
2,702 |
$13K |
| 74178 |
|
339 |
339 |
$8K |
| 75574 |
|
106 |
105 |
$8K |
| 77080 |
|
911 |
911 |
$4K |
| 73221 |
|
50 |
49 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
204 |
203 |
$2K |
| 72100 |
|
396 |
396 |
$2K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
287 |
287 |
$2K |
| 73565 |
|
156 |
156 |
$976.33 |
| 70450 |
Computed tomography, head or brain; without contrast material |
36 |
36 |
$903.02 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
26 |
26 |
$892.56 |
| 73630 |
|
271 |
213 |
$838.07 |
| 72141 |
|
14 |
14 |
$735.14 |
| 76770 |
|
57 |
52 |
$548.05 |
| 36000 |
|
1,408 |
1,249 |
$404.00 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
37 |
37 |
$308.64 |
| 73560 |
|
50 |
50 |
$276.01 |
| 73030 |
|
60 |
46 |
$266.90 |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$192.15 |
| 73502 |
|
25 |
25 |
$191.88 |
| 73610 |
|
16 |
12 |
$32.82 |
| 72070 |
|
16 |
16 |
$17.80 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,396 |
1,245 |
$5.62 |
| 76377 |
|
14 |
13 |
$0.00 |
| 73522 |
|
13 |
13 |
$0.00 |