| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
420 |
381 |
$32K |
| 77066 |
Tomosynthesis, mammo |
366 |
365 |
$25K |
| 76641 |
|
790 |
507 |
$22K |
| 76642 |
|
643 |
599 |
$20K |
| 77065 |
Tomosynthesis, mammo |
431 |
424 |
$19K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
21 |
21 |
$17K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,189 |
1,189 |
$14K |
| 73221 |
|
111 |
101 |
$8K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
708 |
708 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
408 |
408 |
$4K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
117 |
117 |
$4K |
| 76830 |
Ultrasound, transvaginal |
396 |
396 |
$4K |
| 19083 |
|
12 |
12 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
986 |
984 |
$1K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
13 |
13 |
$824.20 |
| 72141 |
|
17 |
17 |
$753.21 |
| 73562 |
|
437 |
307 |
$510.91 |
| 71250 |
|
14 |
14 |
$421.11 |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
17 |
17 |
$416.08 |
| 72100 |
|
300 |
298 |
$338.55 |
| 77080 |
|
180 |
180 |
$206.06 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
24 |
24 |
$174.83 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
41 |
39 |
$160.79 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
16 |
14 |
$125.90 |
| 73030 |
|
164 |
126 |
$125.67 |
| 76770 |
|
12 |
12 |
$0.00 |
| 73630 |
|
41 |
28 |
$0.00 |
| 74018 |
|
12 |
12 |
$0.00 |
| 72070 |
|
14 |
14 |
$0.00 |
| 72040 |
|
72 |
72 |
$0.00 |