| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
33 |
33 |
$2K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
38 |
38 |
$886.12 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
38 |
38 |
$854.30 |
| 70450 |
Computed tomography, head or brain; without contrast material |
15 |
15 |
$664.80 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
13 |
$480.41 |
| 71046 |
Radiologic examination, chest; 2 views |
41 |
40 |
$384.88 |
| 71045 |
Radiologic examination, chest; single view |
39 |
38 |
$290.09 |