| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,573 |
1,573 |
$46K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,514 |
1,514 |
$29K |
| 71046 |
Radiologic examination, chest; 2 views |
2,764 |
2,694 |
$20K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
213 |
210 |
$9K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
228 |
221 |
$9K |
| 71045 |
Radiologic examination, chest; single view |
934 |
790 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
272 |
266 |
$5K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
120 |
101 |
$3K |
| 71250 |
|
111 |
110 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
97 |
97 |
$2K |
| 76830 |
Ultrasound, transvaginal |
100 |
99 |
$2K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
33 |
33 |
$737.96 |
| 71271 |
|
12 |
12 |
$680.62 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$482.24 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
13 |
13 |
$436.28 |
| 72110 |
|
57 |
57 |
$380.35 |
| 73630 |
|
56 |
56 |
$223.92 |
| 73564 |
|
37 |
37 |
$199.67 |
| 74018 |
|
27 |
27 |
$159.64 |
| 76857 |
|
13 |
13 |
$77.41 |
| 73130 |
|
13 |
13 |
$51.40 |
| 73030 |
|
12 |
12 |
$45.98 |