| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
22 |
22 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
236 |
204 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
34 |
31 |
$991.74 |
| 70450 |
Computed tomography, head or brain; without contrast material |
28 |
27 |
$921.80 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
33 |
30 |
$649.36 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
16 |
16 |
$521.28 |
| 76830 |
Ultrasound, transvaginal |
14 |
14 |
$473.35 |
| 71250 |
|
13 |
12 |
$468.26 |
| 71046 |
Radiologic examination, chest; 2 views |
36 |
33 |
$250.99 |
| 74018 |
|
21 |
20 |
$105.90 |