| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71045 |
Radiologic examination, chest; single view |
3,381 |
2,003 |
$6K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
65 |
65 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
248 |
233 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
85 |
82 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
31 |
29 |
$484.01 |
| 71046 |
Radiologic examination, chest; 2 views |
92 |
90 |
$259.15 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
13 |
13 |
$173.22 |
| 73630 |
|
12 |
12 |
$59.38 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
13 |
13 |
$45.44 |
| 77080 |
|
12 |
12 |
$0.00 |