| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
525 |
525 |
$22K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
525 |
525 |
$11K |
| 76642 |
|
124 |
114 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
75 |
75 |
$578.11 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
13 |
$423.28 |
| 77065 |
Tomosynthesis, mammo |
12 |
12 |
$340.80 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$249.32 |