| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
388 |
388 |
$48K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
337 |
321 |
$48K |
| 71046 |
Radiologic examination, chest; 2 views |
1,625 |
1,614 |
$31K |
| 93976 |
|
279 |
262 |
$24K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
94 |
84 |
$19K |
| 76642 |
|
159 |
146 |
$15K |
| 72141 |
|
67 |
66 |
$12K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
209 |
209 |
$10K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
142 |
142 |
$10K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
157 |
157 |
$8K |
| 72100 |
|
308 |
308 |
$8K |
| 73221 |
|
28 |
28 |
$6K |
| 73562 |
|
192 |
146 |
$4K |
| 76830 |
Ultrasound, transvaginal |
61 |
61 |
$3K |
| 72040 |
|
114 |
114 |
$2K |
| 76770 |
|
48 |
48 |
$2K |
| 71250 |
|
12 |
12 |
$1K |
| 73030 |
|
65 |
52 |
$1K |
| 76536 |
|
33 |
29 |
$1K |
| 93882 |
|
29 |
29 |
$1K |
| 77080 |
|
47 |
47 |
$1K |
| 76641 |
|
22 |
15 |
$1K |
| 72114 |
|
30 |
30 |
$1K |
| 72131 |
|
12 |
12 |
$914.53 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
122 |
111 |
$513.82 |
| 73630 |
|
28 |
21 |
$457.78 |
| 73130 |
|
27 |
19 |
$450.27 |
| 76881 |
|
14 |
12 |
$424.73 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
13 |
$362.61 |
| 76376 |
|
135 |
104 |
$236.13 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
56 |
41 |
$44.14 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
14 |
12 |
$0.00 |
| G9638 |
Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
24 |
14 |
$0.00 |