| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9555 |
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries |
78 |
78 |
$14K |
| 93015 |
|
337 |
337 |
$3K |
| A9502 |
Technetium tc-99m tetrofosmin, diagnostic, per study dose |
20 |
20 |
$981.76 |
| 78452 |
Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress |
19 |
19 |
$683.24 |
| J0280 |
Injection, aminophyllin, up to 250 mg |
107 |
107 |
$252.04 |
| 78492 |
|
78 |
78 |
$240.00 |
| J2785 |
Injection, regadenoson, 0.1 mg |
80 |
80 |
$0.00 |
| J1245 |
Injection, dipyridamole, per 10 mg |
37 |
37 |
$0.00 |