| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
207 |
176 |
$39K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
58 |
57 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
86 |
79 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
28 |
26 |
$2K |
| 72141 |
|
15 |
12 |
$1K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
127 |
92 |
$658.82 |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
92 |
89 |
$15.75 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
46 |
45 |
$0.00 |