| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71046 |
Radiologic examination, chest; 2 views |
377 |
375 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
40 |
40 |
$3K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
69 |
69 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
314 |
290 |
$2K |
| 76641 |
|
19 |
19 |
$922.54 |
| 70450 |
Computed tomography, head or brain; without contrast material |
26 |
24 |
$735.77 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$618.02 |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$440.04 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
12 |
12 |
$396.39 |
| 71250 |
|
12 |
12 |
$349.46 |