| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,709 |
1,255 |
$48K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,696 |
1,241 |
$38K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
402 |
382 |
$16K |
| 76642 |
|
710 |
546 |
$15K |
| G0279 |
Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) |
581 |
456 |
$12K |
| 76641 |
|
287 |
176 |
$8K |
| 77066 |
Tomosynthesis, mammo |
174 |
138 |
$5K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
166 |
165 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
84 |
80 |
$4K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
43 |
42 |
$4K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
95 |
90 |
$4K |
| 77065 |
Tomosynthesis, mammo |
105 |
91 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
503 |
451 |
$2K |
| 71250 |
|
49 |
46 |
$945.91 |
| 71046 |
Radiologic examination, chest; 2 views |
166 |
162 |
$926.21 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
26 |
26 |
$506.00 |
| 76376 |
|
167 |
157 |
$449.30 |
| 77080 |
|
54 |
54 |
$306.90 |