| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,178 |
1,178 |
$50K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
1,177 |
1,177 |
$27K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
391 |
387 |
$13K |
| 71046 |
Radiologic examination, chest; 2 views |
1,043 |
1,038 |
$9K |
| 76642 |
|
297 |
278 |
$8K |
| 76830 |
Ultrasound, transvaginal |
182 |
180 |
$5K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
187 |
186 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
45 |
45 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
139 |
138 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
367 |
353 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
38 |
38 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
76 |
76 |
$2K |
| 76376 |
|
201 |
199 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
38 |
38 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
46 |
46 |
$1K |
| 93975 |
|
29 |
29 |
$1K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
39 |
39 |
$1K |
| 93976 |
|
24 |
24 |
$733.44 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
26 |
24 |
$634.14 |
| 77065 |
Tomosynthesis, mammo |
14 |
14 |
$439.74 |
| 73630 |
|
45 |
45 |
$293.85 |
| 72100 |
|
12 |
12 |
$105.24 |
| 73610 |
|
15 |
15 |
$102.45 |