| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
55 |
42 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
65 |
47 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
362 |
278 |
$3K |
| 76801 |
|
35 |
35 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13 |
13 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
68 |
48 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
131 |
104 |
$989.23 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
16 |
16 |
$561.93 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
16 |
16 |
$452.74 |
| 74018 |
|
25 |
24 |
$245.07 |