| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,731 |
1,727 |
$109K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
993 |
990 |
$103K |
| 71250 |
|
2,058 |
2,056 |
$102K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,288 |
2,285 |
$89K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
1,397 |
1,394 |
$85K |
| 76536 |
|
1,718 |
1,716 |
$71K |
| 71046 |
Radiologic examination, chest; 2 views |
3,269 |
3,262 |
$41K |
| 73562 |
|
1,605 |
1,082 |
$25K |
| 93976 |
|
289 |
289 |
$22K |
| 72141 |
|
331 |
331 |
$20K |
| 72110 |
|
954 |
953 |
$18K |
| 76775 |
|
631 |
630 |
$9K |
| 70544 |
|
128 |
127 |
$9K |
| 76641 |
|
198 |
144 |
$8K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
27 |
27 |
$8K |
| 72050 |
|
388 |
387 |
$7K |
| 70450 |
Computed tomography, head or brain; without contrast material |
191 |
190 |
$6K |
| 74183 |
|
57 |
57 |
$4K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
1,027 |
1,016 |
$3K |
| 73630 |
|
178 |
128 |
$2K |
| 75574 |
|
13 |
13 |
$1K |
| 76770 |
|
55 |
55 |
$1K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
26 |
26 |
$1K |
| 74178 |
|
13 |
13 |
$1K |
| 70543 |
|
12 |
12 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
40 |
40 |
$1K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
13 |
13 |
$631.16 |
| 73030 |
|
30 |
25 |
$408.86 |
| 76830 |
Ultrasound, transvaginal |
13 |
13 |
$393.70 |
| 76857 |
|
12 |
12 |
$155.96 |
| 71100 |
|
13 |
13 |
$144.82 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
266 |
265 |
$77.82 |
| 99072 |
|
299 |
293 |
$0.00 |