| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
86 |
81 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
587 |
541 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
295 |
282 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
85 |
80 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
38 |
38 |
$1K |
| 73630 |
|
135 |
123 |
$705.88 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
38 |
38 |
$585.60 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
13 |
$298.36 |
| 73610 |
|
28 |
28 |
$187.90 |
| 73030 |
|
25 |
24 |
$181.37 |
| 73502 |
|
29 |
24 |
$177.73 |
| 73562 |
|
15 |
14 |
$98.89 |