| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
185 |
182 |
$12K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
127 |
121 |
$6K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
214 |
202 |
$5K |
| 71046 |
Radiologic examination, chest; 2 views |
768 |
731 |
$3K |
| 73630 |
|
152 |
122 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
545 |
485 |
$2K |
| 73030 |
|
59 |
52 |
$712.38 |
| 76642 |
|
27 |
16 |
$687.10 |
| 72100 |
|
42 |
42 |
$543.56 |
| 77065 |
Tomosynthesis, mammo |
19 |
13 |
$542.32 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
16 |
16 |
$287.52 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
15 |
15 |
$251.29 |
| 73610 |
|
13 |
13 |
$141.94 |