| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
2,342 |
2,300 |
$173K |
| 77066 |
Tomosynthesis, mammo |
1,289 |
1,198 |
$106K |
| 76642 |
|
2,348 |
2,118 |
$105K |
| 77065 |
Tomosynthesis, mammo |
599 |
512 |
$35K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,550 |
1,525 |
$30K |
| 77049 |
|
41 |
41 |
$27K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
650 |
619 |
$24K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
486 |
467 |
$18K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
1,687 |
1,514 |
$15K |
| 76830 |
Ultrasound, transvaginal |
282 |
277 |
$13K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
82 |
79 |
$12K |
| 74019 |
|
652 |
615 |
$11K |
| 70486 |
|
93 |
83 |
$11K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
135 |
131 |
$7K |
| 76536 |
|
191 |
181 |
$7K |
| 76770 |
|
15 |
14 |
$600.81 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
683 |
651 |
$401.73 |
| 77062 |
|
215 |
195 |
$134.40 |
| 77061 |
|
81 |
68 |
$58.80 |
| A9585 |
Injection, gadobutrol, 0.1 ml |
67 |
65 |
$0.23 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
31 |
25 |
$0.00 |