| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
7,470 |
7,460 |
$487K |
| 90960 |
End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits |
487 |
487 |
$114K |
| 76811 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, detailed |
679 |
573 |
$93K |
| 90961 |
|
342 |
342 |
$64K |
| 76801 |
|
994 |
989 |
$62K |
| 90966 |
|
333 |
331 |
$62K |
| 76813 |
|
584 |
459 |
$54K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
519 |
519 |
$35K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
341 |
340 |
$17K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
146 |
146 |
$10K |
| G0202 |
Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed |
40 |
28 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
33 |
33 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$626.37 |
| 71046 |
Radiologic examination, chest; 2 views |
13 |
13 |
$353.73 |