| Code | Description | Claims | Beneficiaries | Total Paid |
| 71045 |
Radiologic examination, chest; single view |
296 |
264 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
214 |
206 |
$2K |
| 71250 |
|
18 |
18 |
$821.28 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
15 |
15 |
$489.75 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
15 |
15 |
$395.70 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
48 |
46 |
$0.00 |