| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
386 |
378 |
$26K |
| 71250 |
|
255 |
249 |
$19K |
| 71046 |
Radiologic examination, chest; 2 views |
1,887 |
1,796 |
$16K |
| 70450 |
Computed tomography, head or brain; without contrast material |
421 |
400 |
$11K |
| 71045 |
Radiologic examination, chest; single view |
2,218 |
1,609 |
$11K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
109 |
104 |
$8K |
| 71271 |
|
28 |
28 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
26 |
25 |
$944.89 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
13 |
12 |
$604.84 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
14 |
14 |
$488.67 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$196.70 |