| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
712 |
549 |
$74K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
237 |
219 |
$58K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
162 |
158 |
$28K |
| 70450 |
Computed tomography, head or brain; without contrast material |
233 |
223 |
$11K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
150 |
137 |
$8K |
| 70544 |
|
46 |
39 |
$7K |
| 76642 |
|
58 |
53 |
$6K |
| 77065 |
Tomosynthesis, mammo |
46 |
42 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
633 |
446 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
389 |
293 |
$4K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
16 |
14 |
$3K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
97 |
95 |
$2K |
| 19083 |
|
13 |
13 |
$2K |
| 72141 |
|
12 |
12 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
17 |
17 |
$2K |
| 73630 |
|
17 |
12 |
$523.32 |
| 74018 |
|
39 |
26 |
$279.48 |
| 73030 |
|
14 |
14 |
$127.92 |
| 99053 |
|
36 |
34 |
$0.00 |