| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
125 |
124 |
$3K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
113 |
112 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
175 |
169 |
$1K |
| 76641 |
|
72 |
58 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
149 |
122 |
$1K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
16 |
16 |
$849.81 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
12 |
12 |
$317.63 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
13 |
$261.57 |
| 73630 |
|
15 |
12 |
$78.16 |
| 73562 |
|
13 |
12 |
$73.56 |
| 73130 |
|
17 |
17 |
$57.60 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61 |
57 |
$0.00 |