| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
347 |
347 |
$15K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
346 |
346 |
$8K |
| 71046 |
Radiologic examination, chest; 2 views |
168 |
168 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
40 |
39 |
$1K |
| 93975 |
|
28 |
28 |
$1K |
| 76642 |
|
43 |
40 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
43 |
43 |
$978.16 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13 |
13 |
$912.47 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
15 |
15 |
$445.05 |
| 76376 |
|
37 |
37 |
$274.32 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
17 |
17 |
$0.00 |