| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
52 |
52 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
120 |
120 |
$942.61 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
18 |
17 |
$489.75 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
18 |
17 |
$395.70 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$363.00 |
| 71045 |
Radiologic examination, chest; single view |
24 |
24 |
$9.17 |