| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
409 |
380 |
$30K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
496 |
478 |
$23K |
| 71046 |
Radiologic examination, chest; 2 views |
1,429 |
1,315 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
955 |
866 |
$4K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
17 |
17 |
$2K |
| 73562 |
|
42 |
36 |
$577.91 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
17 |
15 |
$546.78 |
| 73630 |
|
44 |
41 |
$422.14 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
17 |
15 |
$406.98 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
14 |
13 |
$382.44 |
| 74018 |
|
13 |
13 |
$72.02 |