| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
846 |
846 |
$90K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
368 |
366 |
$33K |
| 76536 |
|
267 |
261 |
$19K |
| 93971 |
|
109 |
108 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
358 |
353 |
$9K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
27 |
27 |
$2K |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$872.37 |
| 72110 |
|
12 |
12 |
$504.49 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
13 |
13 |
$171.18 |
| A9576 |
Injection, gadoteridol, (prohance multipack), per ml |
12 |
12 |
$66.10 |