| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,071 |
1,071 |
$99K |
| 93976 |
|
378 |
368 |
$43K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
124 |
124 |
$34K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
393 |
392 |
$32K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
107 |
107 |
$30K |
| 76641 |
|
441 |
284 |
$28K |
| 71046 |
Radiologic examination, chest; 2 views |
708 |
707 |
$16K |
| 76642 |
|
128 |
121 |
$9K |
| 72141 |
|
25 |
25 |
$7K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
14 |
14 |
$7K |
| 76536 |
|
46 |
45 |
$3K |
| 72110 |
|
49 |
48 |
$2K |
| 72100 |
|
40 |
40 |
$1K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$940.82 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
31 |
30 |
$638.22 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
15 |
13 |
$337.00 |
| 96160 |
|
57 |
57 |
$48.59 |