| Code | Description | Claims | Beneficiaries | Total Paid |
| 76881 |
|
5,307 |
4,437 |
$221K |
| 93970 |
|
1,336 |
922 |
$145K |
| 93925 |
|
564 |
331 |
$86K |
| 76536 |
|
1,271 |
861 |
$64K |
| 76981 |
|
1,013 |
686 |
$56K |
| 76830 |
Ultrasound, transvaginal |
673 |
450 |
$29K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
465 |
281 |
$24K |
| 93924 |
|
83 |
38 |
$9K |
| 76641 |
|
162 |
44 |
$6K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
109 |
63 |
$4K |
| 76770 |
|
63 |
35 |
$2K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
21 |
12 |
$1K |
| 77080 |
|
69 |
40 |
$836.11 |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
13 |
13 |
$556.28 |
| A9500 |
Technetium tc-99m sestamibi, diagnostic, per study dose |
12 |
12 |
$160.00 |
| 91200 |
|
40 |
12 |
$136.20 |
| 93015 |
|
12 |
12 |
$96.75 |