| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
2,445 |
1,986 |
$107K |
| 71045 |
Radiologic examination, chest; single view |
40,592 |
29,784 |
$103K |
| 70450 |
Computed tomography, head or brain; without contrast material |
6,062 |
5,051 |
$72K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,128 |
816 |
$48K |
| 71046 |
Radiologic examination, chest; 2 views |
5,232 |
4,514 |
$24K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
171 |
141 |
$18K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
535 |
455 |
$18K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,060 |
744 |
$15K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
525 |
483 |
$13K |
| 74018 |
|
2,548 |
1,769 |
$10K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
142 |
128 |
$10K |
| 76641 |
|
210 |
138 |
$8K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
416 |
368 |
$8K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
336 |
304 |
$7K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
195 |
163 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
268 |
245 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
132 |
114 |
$5K |
| 73630 |
|
700 |
572 |
$4K |
| 73610 |
|
294 |
263 |
$3K |
| 70496 |
|
53 |
48 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
43 |
37 |
$2K |
| 76770 |
|
109 |
94 |
$2K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
14 |
13 |
$1K |
| 77066 |
Tomosynthesis, mammo |
14 |
13 |
$1K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
20 |
12 |
$926.24 |
| 49083 |
|
14 |
13 |
$898.60 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
39 |
39 |
$848.53 |
| 93970 |
|
65 |
53 |
$697.41 |
| 70498 |
|
16 |
15 |
$641.47 |
| 99152 |
|
238 |
193 |
$638.49 |
| 93976 |
|
29 |
26 |
$598.01 |
| 73030 |
|
99 |
81 |
$572.23 |
| 73130 |
|
111 |
94 |
$537.30 |
| 76830 |
Ultrasound, transvaginal |
25 |
25 |
$528.03 |
| 72110 |
|
40 |
36 |
$491.29 |
| 76801 |
|
12 |
12 |
$465.02 |
| 76937 |
|
87 |
80 |
$324.02 |
| 73564 |
|
57 |
39 |
$297.56 |
| 73110 |
|
44 |
41 |
$261.33 |
| 73562 |
|
43 |
33 |
$243.28 |
| 73590 |
|
13 |
12 |
$62.74 |
| 99072 |
|
1,272 |
1,216 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
288 |
164 |
$0.00 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
30 |
21 |
$0.00 |