| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
129 |
124 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
745 |
651 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
83 |
76 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
174 |
155 |
$2K |
| 74019 |
|
329 |
289 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
732 |
497 |
$1K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
130 |
128 |
$994.56 |
| 73610 |
|
45 |
40 |
$238.32 |
| 73630 |
|
41 |
36 |
$211.84 |
| 73110 |
|
43 |
37 |
$211.84 |
| 74018 |
|
44 |
40 |
$193.01 |
| 74022 |
|
20 |
17 |
$145.76 |
| 73562 |
|
47 |
39 |
$138.60 |
| 73030 |
|
29 |
26 |
$90.09 |
| 73564 |
|
18 |
14 |
$73.95 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
12 |
12 |
$0.00 |