| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
214 |
210 |
$9K |
| 70450 |
Computed tomography, head or brain; without contrast material |
158 |
156 |
$9K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
174 |
126 |
$5K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
161 |
113 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
615 |
597 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
696 |
669 |
$3K |
| 77080 |
|
12 |
12 |
$117.72 |
| 74018 |
|
14 |
14 |
$72.02 |
| 7025F |
|
12 |
12 |
$0.00 |