| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
34 |
30 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
58 |
57 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
25 |
25 |
$1K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
34 |
30 |
$862.72 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
13 |
$573.40 |
| 71045 |
Radiologic examination, chest; single view |
97 |
92 |
$231.92 |