| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
605 |
563 |
$28K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
340 |
318 |
$4K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
84 |
80 |
$4K |
| 76641 |
|
82 |
55 |
$3K |
| 76536 |
|
59 |
55 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
200 |
182 |
$2K |
| 76830 |
Ultrasound, transvaginal |
30 |
29 |
$917.72 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$712.23 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
12 |
$629.67 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$519.39 |
| 72100 |
|
30 |
27 |
$353.59 |
| 73630 |
|
21 |
13 |
$137.61 |
| A9573 |
Injection, gadopiclenol, 1 ml |
13 |
12 |
$0.00 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
12 |
12 |
$0.00 |