| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
259 |
240 |
$25K |
| 70450 |
Computed tomography, head or brain; without contrast material |
296 |
270 |
$21K |
| 71045 |
Radiologic examination, chest; single view |
2,232 |
1,709 |
$20K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
60 |
54 |
$6K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
170 |
130 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
346 |
297 |
$3K |
| 73630 |
|
117 |
106 |
$2K |
| 73610 |
|
97 |
89 |
$1K |
| 93975 |
|
16 |
13 |
$665.43 |
| 73110 |
|
59 |
40 |
$391.00 |
| 74018 |
|
30 |
27 |
$246.16 |
| 73130 |
|
16 |
13 |
$125.00 |