| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,612 |
1,612 |
$99K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
392 |
372 |
$98K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
399 |
399 |
$94K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,349 |
1,349 |
$85K |
| 76641 |
|
1,034 |
1,028 |
$80K |
| 73221 |
|
170 |
166 |
$43K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
648 |
647 |
$39K |
| 76830 |
Ultrasound, transvaginal |
509 |
508 |
$36K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
132 |
132 |
$35K |
| 71046 |
Radiologic examination, chest; 2 views |
1,832 |
1,812 |
$32K |
| 72141 |
|
113 |
113 |
$25K |
| 76536 |
|
444 |
441 |
$21K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
652 |
652 |
$18K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
38 |
37 |
$16K |
| 71250 |
|
99 |
99 |
$12K |
| 77080 |
|
403 |
403 |
$11K |
| 76770 |
|
180 |
180 |
$11K |
| 77065 |
Tomosynthesis, mammo |
169 |
169 |
$11K |
| 72110 |
|
414 |
414 |
$10K |
| 73564 |
|
328 |
311 |
$9K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
57 |
57 |
$6K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
185 |
184 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
34 |
34 |
$4K |
| 73030 |
|
165 |
165 |
$3K |
| 72100 |
|
118 |
118 |
$2K |
| 73130 |
|
130 |
129 |
$2K |
| 72050 |
|
95 |
94 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12 |
12 |
$1K |
| 73630 |
|
80 |
78 |
$1K |
| 93970 |
|
13 |
12 |
$1K |
| 72040 |
|
44 |
44 |
$854.16 |
| 72070 |
|
42 |
42 |
$731.16 |
| 73110 |
|
16 |
16 |
$284.21 |
| 76882 |
|
13 |
13 |
$240.12 |