| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
299 |
293 |
$15K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
57 |
46 |
$5K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
92 |
85 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
994 |
896 |
$3K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
56 |
45 |
$2K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
13 |
12 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
13 |
$395.36 |
| 71046 |
Radiologic examination, chest; 2 views |
25 |
24 |
$149.96 |