| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 78815 |
Positron emission tomography (PET) for limited area imaging |
14 |
14 |
$15K |
| 76536 |
|
25 |
25 |
$3K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
14 |
14 |
$2K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
26 |
26 |
$829.92 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
14 |
14 |
$762.32 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
17 |
17 |
$559.37 |
| 72141 |
|
16 |
16 |
$0.00 |