| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
55 |
46 |
$4K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
15 |
14 |
$2K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
26 |
25 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
120 |
109 |
$229.71 |
| 71046 |
Radiologic examination, chest; 2 views |
18 |
16 |
$77.33 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
539 |
464 |
$2.52 |
| 99070 |
|
428 |
374 |
$0.00 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
30 |
25 |
$0.00 |