| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,984 |
1,984 |
$210K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,530 |
1,522 |
$146K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,989 |
1,989 |
$92K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
940 |
940 |
$88K |
| 76830 |
Ultrasound, transvaginal |
644 |
644 |
$77K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,202 |
1,190 |
$65K |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,651 |
1,638 |
$63K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
228 |
228 |
$49K |
| 71045 |
Radiologic examination, chest; single view |
4,958 |
4,746 |
$38K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
351 |
351 |
$38K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
364 |
363 |
$34K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
149 |
149 |
$24K |
| 71046 |
Radiologic examination, chest; 2 views |
1,086 |
1,084 |
$16K |
| 76642 |
|
215 |
215 |
$16K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
92 |
92 |
$15K |
| 73221 |
|
76 |
76 |
$15K |
| 76770 |
|
151 |
151 |
$10K |
| 76536 |
|
84 |
84 |
$9K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
173 |
172 |
$7K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
23 |
23 |
$7K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
120 |
118 |
$7K |
| 74178 |
|
14 |
14 |
$5K |
| 74018 |
|
292 |
291 |
$4K |
| 71271 |
|
39 |
39 |
$4K |
| 71250 |
|
50 |
50 |
$3K |
| 73030 |
|
168 |
166 |
$3K |
| 72100 |
|
78 |
78 |
$3K |
| 93971 |
|
67 |
67 |
$3K |
| 73630 |
|
157 |
156 |
$2K |
| 77080 |
|
187 |
187 |
$2K |
| 72141 |
|
12 |
12 |
$2K |
| 93880 |
|
12 |
12 |
$2K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
12 |
12 |
$1K |
| 77065 |
Tomosynthesis, mammo |
14 |
14 |
$1K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
24 |
24 |
$1K |
| 70496 |
|
13 |
13 |
$909.58 |
| 73610 |
|
57 |
57 |
$855.40 |
| 70498 |
|
13 |
13 |
$844.08 |
| 73562 |
|
38 |
38 |
$812.91 |
| 70486 |
|
14 |
14 |
$793.44 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
31 |
29 |
$784.35 |
| 73564 |
|
27 |
27 |
$693.57 |
| 76882 |
|
12 |
12 |
$620.88 |
| 73502 |
|
29 |
29 |
$594.55 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
45 |
45 |
$520.56 |
| 73130 |
|
24 |
24 |
$385.33 |
| 73560 |
|
24 |
24 |
$241.15 |
| 73590 |
|
15 |
15 |
$177.70 |
| 73140 |
|
12 |
12 |
$81.51 |