| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71250 |
|
107 |
82 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
276 |
221 |
$337.39 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12 |
12 |
$0.00 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
21 |
14 |
$0.00 |
| G9756 |
Surgical procedures that included the use of silicone oil |
13 |
12 |
$0.00 |