| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
5,479 |
5,475 |
$544K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
191 |
191 |
$247K |
| 76642 |
|
1,465 |
1,192 |
$103K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
2,269 |
2,268 |
$84K |
| 77066 |
Tomosynthesis, mammo |
654 |
653 |
$82K |
| A9552 |
Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries |
276 |
276 |
$59K |
| 77065 |
Tomosynthesis, mammo |
214 |
209 |
$22K |
| 71046 |
Radiologic examination, chest; 2 views |
500 |
500 |
$10K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
104 |
104 |
$7K |
| 76830 |
Ultrasound, transvaginal |
102 |
102 |
$7K |
| 77085 |
|
166 |
165 |
$5K |
| 77062 |
|
158 |
158 |
$4K |
| 77080 |
|
107 |
107 |
$3K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
39 |
39 |
$372.40 |