| Code | Description | Claims | Beneficiaries | Total Paid |
| 75574 |
|
1,750 |
1,750 |
$345K |
| 76641 |
|
807 |
659 |
$110K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
811 |
808 |
$106K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
686 |
686 |
$92K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
686 |
686 |
$37K |
| 71046 |
Radiologic examination, chest; 2 views |
202 |
199 |
$7K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
2,049 |
1,604 |
$7K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
27 |
27 |
$2K |
| 77066 |
Tomosynthesis, mammo |
12 |
12 |
$2K |
| 77080 |
|
13 |
13 |
$574.60 |