| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
634 |
634 |
$27K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
634 |
634 |
$14K |
| 76642 |
|
124 |
117 |
$3K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
79 |
77 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
205 |
205 |
$2K |
| 76830 |
Ultrasound, transvaginal |
41 |
41 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
45 |
44 |
$962.98 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13 |
13 |
$912.47 |
| 70450 |
Computed tomography, head or brain; without contrast material |
31 |
28 |
$898.46 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
30 |
30 |
$890.99 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
38 |
38 |
$561.83 |
| 77066 |
Tomosynthesis, mammo |
14 |
14 |
$538.72 |
| 93975 |
|
12 |
12 |
$527.88 |
| 77062 |
|
14 |
14 |
$509.60 |
| 76376 |
|
52 |
52 |
$386.58 |
| 73630 |
|
44 |
32 |
$269.52 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
19 |
19 |
$0.00 |