| Code | Description | Claims | Beneficiaries | Total Paid |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
612 |
602 |
$43K |
| 76642 |
|
325 |
260 |
$14K |
| 77066 |
Tomosynthesis, mammo |
29 |
29 |
$3K |
| 77065 |
Tomosynthesis, mammo |
26 |
26 |
$2K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
225 |
215 |
$2K |
| 76830 |
Ultrasound, transvaginal |
14 |
14 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
14 |
14 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$665.06 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
50 |
49 |
$435.17 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
610 |
600 |
$357.16 |
| 77080 |
|
13 |
13 |
$194.43 |