| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
223 |
223 |
$15K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
89 |
89 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
75 |
75 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
216 |
214 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
49 |
49 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
29 |
28 |
$867.72 |
| 71045 |
Radiologic examination, chest; single view |
81 |
78 |
$593.68 |
| 93975 |
|
13 |
13 |
$571.87 |
| 76830 |
Ultrasound, transvaginal |
15 |
15 |
$383.43 |