| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,352 |
1,219 |
$97K |
| 71250 |
|
1,071 |
1,063 |
$56K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
241 |
239 |
$46K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
630 |
628 |
$36K |
| 76536 |
|
388 |
384 |
$36K |
| 71046 |
Radiologic examination, chest; 2 views |
1,659 |
1,650 |
$35K |
| 73562 |
|
1,033 |
825 |
$31K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
406 |
401 |
$31K |
| 76830 |
Ultrasound, transvaginal |
260 |
253 |
$30K |
| 72100 |
|
914 |
906 |
$23K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
149 |
149 |
$18K |
| 74178 |
|
250 |
250 |
$18K |
| 73630 |
|
636 |
520 |
$17K |
| 77080 |
|
444 |
444 |
$15K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
344 |
338 |
$14K |
| 73030 |
|
519 |
466 |
$13K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
53 |
53 |
$11K |
| 72040 |
|
282 |
280 |
$8K |
| 93975 |
|
316 |
171 |
$5K |
| 93971 |
|
25 |
25 |
$3K |
| 76775 |
|
53 |
53 |
$3K |
| 76770 |
|
304 |
170 |
$2K |
| 73560 |
|
90 |
64 |
$2K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
1,005 |
993 |
$2K |
| 93970 |
|
12 |
12 |
$2K |
| 73130 |
|
51 |
42 |
$1K |
| 73610 |
|
59 |
55 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$999.66 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
14 |
14 |
$717.38 |
| 76870 |
|
12 |
12 |
$646.39 |
| 72070 |
|
24 |
24 |
$441.87 |
| 73502 |
|
13 |
13 |
$419.94 |
| 77072 |
|
14 |
14 |
$397.24 |
| 76882 |
|
13 |
13 |
$353.45 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
30 |
27 |
$337.88 |
| 73590 |
|
14 |
13 |
$271.42 |