| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
2,571 |
2,096 |
$785K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
3,619 |
2,638 |
$748K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,836 |
4,869 |
$582K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
2,580 |
2,117 |
$476K |
| 73221 |
|
1,577 |
1,208 |
$341K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
4,839 |
4,636 |
$308K |
| 76830 |
Ultrasound, transvaginal |
4,628 |
4,446 |
$296K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
1,422 |
1,301 |
$294K |
| 74178 |
|
914 |
907 |
$253K |
| 72141 |
|
1,224 |
1,106 |
$244K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
5,799 |
4,832 |
$227K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,677 |
2,611 |
$203K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
2,053 |
1,996 |
$181K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
126 |
125 |
$170K |
| 72197 |
|
319 |
316 |
$104K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
1,750 |
1,711 |
$97K |
| 76642 |
|
1,462 |
1,103 |
$97K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
4,091 |
3,972 |
$85K |
| 75574 |
|
219 |
218 |
$57K |
| 76536 |
|
958 |
895 |
$51K |
| 76801 |
|
662 |
654 |
$48K |
| 77066 |
Tomosynthesis, mammo |
326 |
326 |
$44K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
641 |
628 |
$38K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,972 |
2,954 |
$27K |
| 70486 |
|
218 |
218 |
$26K |
| 72156 |
|
80 |
78 |
$26K |
| 73718 |
|
115 |
99 |
$26K |
| 76981 |
|
283 |
282 |
$24K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
482 |
482 |
$23K |
| 70450 |
Computed tomography, head or brain; without contrast material |
238 |
233 |
$21K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
144 |
143 |
$20K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
140 |
137 |
$20K |
| 77065 |
Tomosynthesis, mammo |
192 |
143 |
$17K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
87 |
87 |
$17K |
| 72146 |
|
74 |
70 |
$12K |
| 76377 |
|
656 |
628 |
$11K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
211 |
211 |
$11K |
| 76770 |
|
157 |
135 |
$10K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
116 |
116 |
$10K |
| 74183 |
|
26 |
26 |
$8K |
| 70491 |
|
39 |
39 |
$7K |
| 71250 |
|
52 |
52 |
$6K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
67 |
67 |
$5K |
| 77085 |
|
86 |
86 |
$4K |
| 77061 |
|
46 |
26 |
$4K |
| 93976 |
|
27 |
27 |
$4K |
| 76857 |
|
86 |
84 |
$3K |
| 71271 |
|
39 |
29 |
$3K |
| 76813 |
|
25 |
25 |
$3K |
| 76882 |
|
14 |
12 |
$363.86 |
| 71046 |
Radiologic examination, chest; 2 views |
12 |
12 |
$324.04 |
| 76376 |
|
88 |
84 |
$291.91 |
| Q9965 |
Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml |
191 |
177 |
$122.73 |