| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,989 |
1,959 |
$123K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
401 |
255 |
$63K |
| 76642 |
|
1,744 |
1,007 |
$36K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,799 |
1,892 |
$32K |
| 77066 |
Tomosynthesis, mammo |
502 |
374 |
$22K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
244 |
176 |
$18K |
| 77065 |
Tomosynthesis, mammo |
308 |
201 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
782 |
571 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
36 |
28 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
16 |
13 |
$915.71 |
| 72100 |
|
119 |
55 |
$855.12 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
24 |
12 |
$794.71 |
| 71045 |
Radiologic examination, chest; single view |
99 |
78 |
$724.51 |
| 76830 |
Ultrasound, transvaginal |
14 |
14 |
$713.46 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$553.78 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
17 |
13 |
$491.79 |
| 76536 |
|
14 |
12 |
$439.67 |
| 73562 |
|
41 |
26 |
$301.38 |
| 74018 |
|
26 |
18 |
$227.96 |
| 99053 |
|
14 |
14 |
$226.32 |
| 76376 |
|
17 |
14 |
$145.07 |
| 73630 |
|
23 |
15 |
$142.51 |
| 73610 |
|
15 |
13 |
$110.35 |
| 73130 |
|
19 |
13 |
$107.75 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
25 |
13 |
$90.18 |
| 71250 |
|
56 |
53 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
14 |
14 |
$0.00 |