| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,742 |
2,741 |
$390K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
87 |
87 |
$206K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
583 |
582 |
$199K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,700 |
2,699 |
$154K |
| 71046 |
Radiologic examination, chest; 2 views |
4,031 |
4,011 |
$114K |
| 71250 |
|
1,026 |
1,026 |
$111K |
| 76641 |
|
716 |
655 |
$101K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
522 |
522 |
$80K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
224 |
222 |
$73K |
| 75561 |
|
130 |
130 |
$53K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
158 |
158 |
$47K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
179 |
179 |
$36K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
1,337 |
1,312 |
$26K |
| 77080 |
|
856 |
852 |
$21K |
| 76830 |
Ultrasound, transvaginal |
111 |
111 |
$16K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
50 |
50 |
$10K |
| 75574 |
|
31 |
31 |
$8K |
| 77089 |
|
698 |
695 |
$8K |
| 70486 |
|
50 |
50 |
$7K |
| 72197 |
|
13 |
13 |
$6K |
| 73630 |
|
175 |
140 |
$6K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
640 |
603 |
$5K |
| 72141 |
|
27 |
27 |
$5K |
| 74183 |
|
13 |
13 |
$5K |
| 70491 |
|
24 |
24 |
$5K |
| 77066 |
Tomosynthesis, mammo |
24 |
24 |
$4K |
| 76536 |
|
36 |
36 |
$4K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
12 |
12 |
$2K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
61 |
50 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
17 |
17 |
$2K |
| G0296 |
Counseling visit to discuss need for lung cancer screening using low dose ct scan (ldct) (service is for eligibility determination and shared decision making) |
85 |
84 |
$2K |
| 72100 |
|
26 |
26 |
$1K |
| 73030 |
|
31 |
26 |
$986.08 |
| 77072 |
|
16 |
16 |
$484.16 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
22 |
22 |
$276.64 |
| 99429 |
|
40 |
40 |
$0.00 |