| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74183 |
|
1,335 |
1,333 |
$147K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
1,836 |
1,836 |
$77K |
| 71250 |
|
1,488 |
1,488 |
$69K |
| 76536 |
|
1,230 |
1,230 |
$48K |
| 76641 |
|
957 |
732 |
$46K |
| 74178 |
|
270 |
270 |
$26K |
| 71046 |
Radiologic examination, chest; 2 views |
1,410 |
1,409 |
$19K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
29 |
29 |
$12K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
65 |
65 |
$8K |
| 73562 |
|
613 |
412 |
$8K |
| 93976 |
|
107 |
107 |
$7K |
| 76775 |
|
404 |
403 |
$6K |
| 72110 |
|
266 |
266 |
$5K |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
1,085 |
1,084 |
$4K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
26 |
26 |
$3K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
47 |
38 |
$2K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
27 |
27 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
24 |
24 |
$1K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
34 |
34 |
$1K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
14 |
14 |
$1K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
14 |
14 |
$655.72 |
| 72050 |
|
29 |
29 |
$601.99 |
| 76770 |
|
24 |
24 |
$586.88 |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$309.19 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
358 |
358 |
$263.99 |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
12 |
12 |
$178.21 |
| 76857 |
|
12 |
12 |
$139.38 |
| 77080 |
|
12 |
12 |
$119.28 |
| 99072 |
|
287 |
281 |
$0.00 |