| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
613 |
511 |
$60K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
575 |
479 |
$21K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
293 |
275 |
$21K |
| 76830 |
Ultrasound, transvaginal |
253 |
232 |
$20K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
201 |
194 |
$16K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
132 |
122 |
$16K |
| 76642 |
|
269 |
184 |
$13K |
| 71046 |
Radiologic examination, chest; 2 views |
820 |
774 |
$12K |
| 77066 |
Tomosynthesis, mammo |
70 |
56 |
$7K |
| 77065 |
Tomosynthesis, mammo |
62 |
43 |
$5K |
| 76536 |
|
70 |
68 |
$5K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
27 |
25 |
$4K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
264 |
241 |
$2K |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
123 |
115 |
$2K |
| 72110 |
|
78 |
76 |
$2K |
| 77062 |
|
46 |
32 |
$1K |
| 77061 |
|
27 |
13 |
$722.85 |
| 73564 |
|
21 |
15 |
$441.06 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
32 |
28 |
$330.70 |
| 73030 |
|
16 |
13 |
$294.58 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
14 |
14 |
$262.06 |