| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
1,207 |
1,192 |
$16K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
451 |
450 |
$16K |
| 71045 |
Radiologic examination, chest; single view |
2,417 |
2,303 |
$8K |
| 71046 |
Radiologic examination, chest; 2 views |
1,202 |
1,191 |
$7K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
12 |
12 |
$2K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
17 |
17 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
24 |
24 |
$531.05 |
| 76830 |
Ultrasound, transvaginal |
13 |
13 |
$458.01 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
24 |
24 |
$449.48 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
13 |
13 |
$428.76 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
14 |
$420.88 |
| 76857 |
|
15 |
15 |
$376.55 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
15 |
15 |
$323.69 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
431 |
320 |
$0.00 |