| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
488 |
425 |
$16K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
242 |
214 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
43 |
43 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
151 |
129 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
378 |
354 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
285 |
268 |
$1K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
33 |
27 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
30 |
27 |
$1K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$395.45 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
17 |
16 |
$370.55 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
12 |
12 |
$287.60 |
| 73562 |
|
12 |
12 |
$191.90 |
| 73610 |
|
13 |
13 |
$186.55 |
| 73630 |
|
12 |
12 |
$118.25 |