| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
206 |
151 |
$5K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
80 |
76 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
61 |
59 |
$4K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
174 |
139 |
$4K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
97 |
97 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
434 |
394 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
589 |
543 |
$2K |
| 73630 |
|
129 |
123 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
24 |
18 |
$680.14 |
| 73030 |
|
75 |
71 |
$592.95 |
| 76830 |
Ultrasound, transvaginal |
22 |
17 |
$460.54 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
17 |
13 |
$253.12 |
| 73610 |
|
21 |
17 |
$210.76 |
| 73564 |
|
15 |
14 |
$161.98 |
| 73130 |
|
15 |
15 |
$107.40 |