| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
560 |
515 |
$43K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
156 |
130 |
$32K |
| 76642 |
|
514 |
416 |
$25K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
184 |
174 |
$23K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
326 |
301 |
$22K |
| 77066 |
Tomosynthesis, mammo |
147 |
142 |
$15K |
| 71046 |
Radiologic examination, chest; 2 views |
685 |
642 |
$14K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
97 |
77 |
$14K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
208 |
191 |
$12K |
| 77065 |
Tomosynthesis, mammo |
146 |
133 |
$12K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
104 |
100 |
$10K |
| 76830 |
Ultrasound, transvaginal |
146 |
128 |
$8K |
| 72141 |
|
57 |
55 |
$7K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
41 |
38 |
$6K |
| 70544 |
|
52 |
42 |
$6K |
| 77080 |
|
214 |
194 |
$4K |
| 76801 |
|
36 |
33 |
$3K |
| 73562 |
|
136 |
102 |
$3K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
211 |
172 |
$2K |
| 76536 |
|
32 |
27 |
$2K |
| 72100 |
|
82 |
76 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
27 |
27 |
$2K |
| 73030 |
|
91 |
71 |
$1K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
51 |
44 |
$1K |
| 73560 |
|
44 |
32 |
$693.93 |
| 73564 |
|
29 |
12 |
$684.28 |
| 72110 |
|
29 |
24 |
$663.31 |
| 76377 |
|
62 |
51 |
$646.99 |
| 73630 |
|
25 |
16 |
$357.14 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
49 |
35 |
$300.50 |
| 72072 |
|
13 |
13 |
$258.10 |
| 73610 |
|
13 |
13 |
$237.12 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
226 |
198 |
$180.64 |
| 82565 |
|
21 |
18 |
$0.00 |