| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,166 |
941 |
$63K |
| 76641 |
|
566 |
323 |
$29K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
469 |
424 |
$16K |
| 73562 |
|
856 |
527 |
$14K |
| 77066 |
Tomosynthesis, mammo |
208 |
164 |
$14K |
| 76830 |
Ultrasound, transvaginal |
366 |
339 |
$13K |
| 93975 |
|
451 |
405 |
$13K |
| 71046 |
Radiologic examination, chest; 2 views |
955 |
845 |
$12K |
| 77065 |
Tomosynthesis, mammo |
201 |
147 |
$12K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
170 |
140 |
$11K |
| 72110 |
|
422 |
374 |
$8K |
| 73030 |
|
456 |
349 |
$5K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
91 |
69 |
$5K |
| 93976 |
|
90 |
84 |
$3K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
20 |
12 |
$2K |
| 73630 |
|
211 |
165 |
$2K |
| 76770 |
|
56 |
51 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
46 |
39 |
$1K |
| 73130 |
|
107 |
84 |
$1K |
| 72050 |
|
60 |
55 |
$925.86 |
| 76857 |
|
71 |
65 |
$794.29 |
| 76642 |
|
23 |
13 |
$720.00 |
| 72072 |
|
65 |
64 |
$686.76 |
| G0204 |
Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral |
15 |
14 |
$664.85 |
| G0202 |
Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed |
352 |
180 |
$572.60 |
| 71045 |
Radiologic examination, chest; single view |
78 |
77 |
$482.54 |
| 72220 |
|
20 |
16 |
$450.53 |
| 71020 |
|
34 |
27 |
$347.28 |
| 72114 |
|
44 |
42 |
$300.93 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
78 |
74 |
$139.34 |
| 76536 |
|
30 |
29 |
$112.91 |
| 73521 |
|
15 |
15 |
$0.00 |