| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
365 |
346 |
$21K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
64 |
63 |
$6K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
110 |
105 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
1,136 |
839 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
597 |
550 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
75 |
70 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
68 |
64 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
84 |
84 |
$1K |
| 73610 |
|
34 |
28 |
$615.98 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
32 |
32 |
$551.36 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
15 |
13 |
$539.25 |
| 73630 |
|
33 |
28 |
$413.85 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
12 |
12 |
$413.65 |
| 93970 |
|
25 |
25 |
$249.87 |
| 73130 |
|
20 |
14 |
$247.05 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
17 |
13 |
$147.68 |
| 73030 |
|
14 |
12 |
$82.92 |
| 74018 |
|
12 |
12 |
$49.23 |
| 99053 |
|
108 |
93 |
$39.00 |