| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
511 |
428 |
$34K |
| 71046 |
Radiologic examination, chest; 2 views |
1,517 |
1,209 |
$18K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
244 |
232 |
$13K |
| 76830 |
Ultrasound, transvaginal |
183 |
175 |
$11K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
458 |
377 |
$8K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
455 |
385 |
$8K |
| A9585 |
Injection, gadobutrol, 0.1 ml |
140 |
127 |
$5K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
32 |
26 |
$4K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
109 |
73 |
$3K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
14 |
14 |
$2K |
| 71250 |
|
32 |
26 |
$2K |
| 76536 |
|
29 |
25 |
$2K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
19 |
13 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
16 |
13 |
$1K |
| Q9966 |
Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml |
71 |
56 |
$1K |
| 94729 |
|
30 |
26 |
$711.06 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
13 |
$634.80 |
| 73630 |
|
33 |
25 |
$393.58 |
| 94726 |
|
19 |
14 |
$368.84 |
| 73030 |
|
18 |
14 |
$311.93 |
| 94060 |
|
12 |
12 |
$273.63 |
| 73562 |
|
15 |
12 |
$237.54 |