| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
537 |
527 |
$35K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
361 |
359 |
$21K |
| 70450 |
Computed tomography, head or brain; without contrast material |
505 |
497 |
$18K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
103 |
103 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
526 |
488 |
$3K |
| 72131 |
|
26 |
26 |
$1K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
12 |
12 |
$923.97 |
| 72128 |
|
12 |
12 |
$499.86 |
| 71046 |
Radiologic examination, chest; 2 views |
15 |
15 |
$99.90 |