| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
228 |
217 |
$15K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
121 |
119 |
$5K |
| 71046 |
Radiologic examination, chest; 2 views |
629 |
624 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
325 |
307 |
$1K |
| 99152 |
|
150 |
125 |
$636.80 |
| 73630 |
|
40 |
40 |
$412.45 |
| 72100 |
|
26 |
25 |
$314.04 |
| 73030 |
|
27 |
26 |
$312.00 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
13 |
$234.52 |
| 73610 |
|
14 |
14 |
$225.89 |
| 73564 |
|
16 |
16 |
$172.08 |
| 73130 |
|
15 |
13 |
$161.45 |
| 74018 |
|
15 |
15 |
$54.70 |