| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 78815 |
Positron emission tomography (PET) for limited area imaging |
295 |
295 |
$185K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
237 |
237 |
$22K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
26 |
26 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$1K |
| 76642 |
|
28 |
28 |
$1K |
| 76830 |
Ultrasound, transvaginal |
13 |
13 |
$933.36 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$802.55 |