| Code | Description | Claims | Beneficiaries | Total Paid |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
371 |
368 |
$10K |
| 70450 |
Computed tomography, head or brain; without contrast material |
680 |
665 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
1,441 |
1,419 |
$6K |
| 71045 |
Radiologic examination, chest; single view |
2,660 |
2,474 |
$6K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
184 |
183 |
$4K |
| 71250 |
|
12 |
12 |
$95.29 |
| 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) |
1,724 |
1,674 |
$0.00 |