| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 93923 |
|
2,080 |
2,054 |
$67K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
739 |
731 |
$53K |
| 93970 |
|
4,095 |
3,936 |
$51K |
| 93925 |
|
3,489 |
3,457 |
$44K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
484 |
443 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,915 |
4,345 |
$33K |
| 73725 |
|
1,498 |
1,452 |
$27K |
| 72198 |
|
1,423 |
1,416 |
$22K |
| 71250 |
|
366 |
365 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,725 |
1,710 |
$19K |
| 74185 |
|
1,012 |
1,008 |
$17K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
127 |
127 |
$14K |
| 93978 |
|
1,262 |
1,254 |
$8K |
| 36478 |
|
77 |
70 |
$7K |
| 93971 |
|
344 |
309 |
$7K |
| 93702 |
|
971 |
964 |
$5K |
| 74178 |
|
144 |
143 |
$4K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
256 |
255 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
328 |
326 |
$3K |
| 93880 |
|
330 |
329 |
$3K |
| 76376 |
|
463 |
457 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
400 |
397 |
$2K |
| 93975 |
|
65 |
65 |
$2K |
| 76536 |
|
129 |
127 |
$1K |
| 72265 |
|
381 |
379 |
$973.97 |
| 73562 |
|
120 |
118 |
$893.69 |
| 72141 |
|
12 |
12 |
$884.31 |
| 77002 |
|
206 |
94 |
$305.36 |
| 93926 |
|
48 |
42 |
$281.82 |
| 20610 |
|
209 |
95 |
$161.54 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
13 |
$107.88 |
| 80047 |
|
28 |
28 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
28 |
28 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
14 |
13 |
$0.00 |
| J7321 |
Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose |
94 |
43 |
$0.00 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
187 |
187 |
$0.00 |
| 72100 |
|
48 |
48 |
$0.00 |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
17 |
17 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
12 |
12 |
$0.00 |