| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
304 |
287 |
$14K |
| 70450 |
Computed tomography, head or brain; without contrast material |
238 |
216 |
$13K |
| 71045 |
Radiologic examination, chest; single view |
743 |
655 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
45 |
44 |
$2K |
| 76376 |
|
451 |
414 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
199 |
197 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
28 |
26 |
$907.96 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
28 |
26 |
$686.38 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
13 |
$191.88 |