| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76770 |
|
125 |
124 |
$15K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
129 |
122 |
$11K |
| 71045 |
Radiologic examination, chest; single view |
1,010 |
713 |
$7K |
| 70450 |
Computed tomography, head or brain; without contrast material |
151 |
144 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
571 |
459 |
$6K |
| 74018 |
|
632 |
422 |
$6K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
34 |
34 |
$5K |
| 73630 |
|
90 |
75 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
19 |
19 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
17 |
14 |
$1K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$703.68 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
14 |
$490.01 |
| 73110 |
|
27 |
25 |
$324.19 |
| 99053 |
|
94 |
89 |
$0.00 |