| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74183 |
|
1,247 |
1,242 |
$134K |
| 71250 |
|
2,225 |
2,219 |
$105K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
2,433 |
2,431 |
$102K |
| 76536 |
|
1,145 |
1,145 |
$45K |
| 74178 |
|
485 |
484 |
$41K |
| 71046 |
Radiologic examination, chest; 2 views |
1,908 |
1,906 |
$26K |
| 73562 |
|
1,144 |
728 |
$18K |
| 72110 |
|
587 |
584 |
$11K |
| 93976 |
|
167 |
167 |
$9K |
| 76775 |
|
513 |
513 |
$8K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
13 |
13 |
$5K |
| 72050 |
|
209 |
209 |
$4K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
1,012 |
1,008 |
$4K |
| 76770 |
|
74 |
74 |
$3K |
| 74170 |
|
41 |
41 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
58 |
58 |
$2K |
| 73630 |
|
155 |
111 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
26 |
26 |
$2K |
| 72197 |
|
25 |
25 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
40 |
39 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
32 |
32 |
$1K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
15 |
15 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
36 |
36 |
$898.50 |
| 76857 |
|
38 |
38 |
$571.00 |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
12 |
12 |
$544.56 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
13 |
$527.87 |
| 73030 |
|
36 |
30 |
$319.40 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
291 |
291 |
$141.21 |
| A9581 |
Injection, gadoxetate disodium, 1 ml |
69 |
69 |
$0.00 |
| 99072 |
|
331 |
329 |
$0.00 |