| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
1,141 |
1,135 |
$156K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,107 |
1,029 |
$100K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
883 |
880 |
$76K |
| 73630 |
|
2,035 |
1,488 |
$37K |
| 72141 |
|
365 |
364 |
$28K |
| 73221 |
|
273 |
256 |
$27K |
| 73130 |
|
1,311 |
919 |
$24K |
| 76536 |
|
499 |
499 |
$23K |
| 73610 |
|
1,062 |
820 |
$20K |
| 73562 |
|
885 |
702 |
$19K |
| 72110 |
|
577 |
574 |
$15K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
191 |
191 |
$15K |
| 73110 |
|
655 |
527 |
$14K |
| 73030 |
|
776 |
673 |
$14K |
| 71046 |
Radiologic examination, chest; 2 views |
662 |
659 |
$11K |
| 76770 |
|
204 |
204 |
$11K |
| 73564 |
|
388 |
365 |
$10K |
| 74018 |
|
545 |
540 |
$9K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
65 |
65 |
$8K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
439 |
419 |
$8K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
91 |
91 |
$5K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
851 |
834 |
$5K |
| 72170 |
|
233 |
232 |
$3K |
| 73560 |
|
172 |
159 |
$3K |
| 73502 |
|
126 |
125 |
$3K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
14 |
14 |
$2K |
| 76881 |
|
32 |
28 |
$1K |
| 76642 |
|
19 |
13 |
$941.55 |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
13 |
13 |
$851.16 |
| 73080 |
|
46 |
40 |
$816.50 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$375.63 |
| 72050 |
|
12 |
12 |
$315.00 |
| 73090 |
|
15 |
12 |
$240.75 |
| 77073 |
|
16 |
16 |
$199.72 |
| 73521 |
|
12 |
12 |
$160.20 |
| A9578 |
Injection, gadobenate dimeglumine (multihance multipack), per ml |
606 |
577 |
$28.00 |