| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
773 |
773 |
$25K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
772 |
772 |
$20K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
121 |
120 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
872 |
758 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
67 |
67 |
$2K |
| 76642 |
|
56 |
56 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$887.28 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
15 |
15 |
$741.94 |
| 71046 |
Radiologic examination, chest; 2 views |
74 |
74 |
$631.75 |