| Code | Description | Claims | Beneficiaries | Total Paid |
| 70486 |
|
41 |
41 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$1K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$455.11 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
12 |
12 |
$0.00 |
| G9638 |
Final reports without documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
14 |
14 |
$0.00 |