| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
414 |
375 |
$28K |
| 71046 |
Radiologic examination, chest; 2 views |
2,460 |
2,206 |
$14K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
132 |
105 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
144 |
112 |
$5K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
29 |
25 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
846 |
740 |
$4K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
102 |
87 |
$3K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
101 |
86 |
$2K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
17 |
12 |
$360.65 |
| 73562 |
|
35 |
28 |
$355.32 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
13 |
12 |
$265.60 |
| 73630 |
|
12 |
12 |
$110.86 |