| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71046 |
Radiologic examination, chest; 2 views |
335 |
333 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
186 |
182 |
$1K |
| 76642 |
|
41 |
41 |
$1K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
15 |
15 |
$950.29 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
19 |
19 |
$587.70 |
| 70450 |
Computed tomography, head or brain; without contrast material |
16 |
16 |
$533.70 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
19 |
19 |
$474.84 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
17 |
15 |
$467.50 |
| 72110 |
|
13 |
13 |
$188.77 |
| 74018 |
|
23 |
23 |
$178.42 |
| 73630 |
|
14 |
13 |
$114.45 |