| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,572 |
1,563 |
$123K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
601 |
600 |
$37K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
397 |
395 |
$28K |
| 71250 |
|
106 |
106 |
$8K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
190 |
190 |
$7K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
190 |
190 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
50 |
50 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
91 |
90 |
$564.88 |
| 71046 |
Radiologic examination, chest; 2 views |
36 |
36 |
$336.73 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
246 |
234 |
$0.00 |