| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
52 |
52 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
233 |
217 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
31 |
31 |
$1K |
| 76830 |
Ultrasound, transvaginal |
28 |
28 |
$900.00 |
| 70450 |
Computed tomography, head or brain; without contrast material |
27 |
27 |
$851.26 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
31 |
31 |
$817.78 |
| 76801 |
|
13 |
12 |
$695.74 |
| 71046 |
Radiologic examination, chest; 2 views |
80 |
77 |
$675.38 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
16 |
15 |
$590.61 |
| 76857 |
|
16 |
16 |
$200.20 |