| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,285 |
1,119 |
$29K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,269 |
1,103 |
$25K |
| 70450 |
Computed tomography, head or brain; without contrast material |
378 |
364 |
$20K |
| 71045 |
Radiologic examination, chest; single view |
3,241 |
2,339 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
688 |
656 |
$3K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
124 |
98 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
52 |
43 |
$2K |
| 76642 |
|
71 |
61 |
$1K |
| 77065 |
Tomosynthesis, mammo |
31 |
14 |
$774.48 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
50 |
31 |
$581.35 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
40 |
39 |
$536.85 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
15 |
14 |
$501.36 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
13 |
$467.35 |
| 76801 |
|
13 |
13 |
$467.35 |
| 73562 |
|
63 |
54 |
$350.63 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
13 |
13 |
$347.50 |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$310.25 |
| 93970 |
|
46 |
43 |
$308.36 |