| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
371 |
319 |
$9K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
371 |
319 |
$8K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
162 |
160 |
$6K |
| 70450 |
Computed tomography, head or brain; without contrast material |
26 |
24 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
392 |
306 |
$2K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
12 |
12 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
29 |
29 |
$739.47 |
| 71046 |
Radiologic examination, chest; 2 views |
115 |
114 |
$571.78 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
15 |
15 |
$533.99 |
| 77080 |
|
29 |
29 |
$251.25 |