| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
472 |
446 |
$56K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
319 |
319 |
$39K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
374 |
371 |
$38K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
230 |
230 |
$20K |
| 71046 |
Radiologic examination, chest; 2 views |
1,822 |
1,772 |
$17K |
| 76830 |
Ultrasound, transvaginal |
316 |
315 |
$16K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
330 |
330 |
$15K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
192 |
189 |
$10K |
| 73630 |
|
1,092 |
982 |
$8K |
| 73222 |
|
43 |
41 |
$8K |
| 73610 |
|
971 |
909 |
$8K |
| 77002 |
|
109 |
108 |
$7K |
| 72100 |
|
346 |
344 |
$5K |
| 73562 |
|
492 |
441 |
$5K |
| 23350 |
|
40 |
40 |
$5K |
| 73110 |
|
523 |
474 |
$4K |
| 73030 |
|
315 |
289 |
$3K |
| 73130 |
|
339 |
305 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
26 |
26 |
$3K |
| 73221 |
|
13 |
12 |
$2K |
| 72141 |
|
13 |
13 |
$2K |
| 76376 |
|
104 |
102 |
$1K |
| 73140 |
|
187 |
183 |
$1K |
| 73502 |
|
94 |
93 |
$1K |
| 70486 |
|
12 |
12 |
$928.80 |
| 76770 |
|
15 |
15 |
$797.96 |
| 76536 |
|
15 |
15 |
$703.02 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
12 |
12 |
$552.31 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
54 |
54 |
$530.09 |
| 73564 |
|
38 |
28 |
$471.73 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
24 |
24 |
$356.89 |
| 74019 |
|
13 |
13 |
$169.92 |
| 73590 |
|
14 |
12 |
$107.00 |
| 72040 |
|
12 |
12 |
$102.72 |
| 73080 |
|
12 |
12 |
$88.08 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
17 |
13 |
$9.62 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
230 |
230 |
$0.00 |