| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
1,172 |
1,087 |
$130K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
848 |
832 |
$44K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
492 |
475 |
$35K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
362 |
359 |
$28K |
| 73221 |
|
131 |
125 |
$12K |
| 76641 |
|
142 |
104 |
$8K |
| 71046 |
Radiologic examination, chest; 2 views |
364 |
356 |
$6K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
178 |
170 |
$6K |
| 72100 |
|
214 |
213 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
58 |
58 |
$4K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
38 |
38 |
$3K |
| 72197 |
|
14 |
14 |
$2K |
| 73560 |
|
115 |
85 |
$1K |
| 76536 |
|
18 |
13 |
$1K |
| 77080 |
|
142 |
138 |
$1K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
14 |
14 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
12 |
12 |
$573.64 |
| 76770 |
|
13 |
13 |
$377.71 |
| 73030 |
|
18 |
13 |
$327.50 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
60 |
58 |
$180.45 |
| 99072 |
|
2,222 |
2,146 |
$20.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12 |
12 |
$12.00 |