| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
102 |
101 |
$9K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
41 |
41 |
$4K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
35 |
35 |
$3K |
| 70450 |
Computed tomography, head or brain; without contrast material |
70 |
70 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
304 |
272 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
121 |
120 |
$1K |
| 93975 |
|
12 |
12 |
$930.32 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
14 |
13 |
$532.89 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
13 |
13 |
$387.87 |
| 74018 |
|
24 |
16 |
$162.36 |