| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
68 |
67 |
$5K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
30 |
28 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
214 |
212 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
14 |
12 |
$497.48 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
20 |
20 |
$452.68 |
| 71045 |
Radiologic examination, chest; single view |
120 |
104 |
$401.78 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
16 |
16 |
$282.13 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
13 |
$254.68 |