| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
240 |
205 |
$15K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
42 |
42 |
$5K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
244 |
209 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$1K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
13 |
13 |
$533.32 |
| 82565 |
|
104 |
95 |
$432.04 |
| 71250 |
|
14 |
14 |
$422.10 |