| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
85 |
81 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
26 |
26 |
$1K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
71 |
70 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
213 |
209 |
$1K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
20 |
20 |
$950.06 |
| 76642 |
|
31 |
25 |
$932.37 |
| 71045 |
Radiologic examination, chest; single view |
220 |
215 |
$541.04 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$476.68 |