| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,763 |
2,759 |
$243K |
| 76641 |
|
1,379 |
1,156 |
$121K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,725 |
2,721 |
$98K |
| 93976 |
|
415 |
404 |
$59K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
337 |
337 |
$34K |
| 93890 |
|
168 |
168 |
$24K |
| 93886 |
|
170 |
170 |
$20K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
66 |
63 |
$18K |
| 93892 |
|
152 |
152 |
$16K |
| 71046 |
Radiologic examination, chest; 2 views |
628 |
621 |
$15K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
171 |
168 |
$11K |
| 76536 |
|
95 |
95 |
$7K |
| 77080 |
|
103 |
97 |
$4K |
| 77065 |
Tomosynthesis, mammo |
28 |
28 |
$3K |
| 73562 |
|
83 |
72 |
$2K |
| 72110 |
|
50 |
50 |
$2K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$1K |
| 76770 |
|
13 |
12 |
$978.96 |
| 76642 |
|
15 |
15 |
$957.20 |
| 73630 |
|
31 |
29 |
$763.99 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
31 |
27 |
$242.82 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54 |
54 |
$0.00 |