| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74183 |
|
26 |
26 |
$4K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
36 |
35 |
$2K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
14 |
14 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
71 |
70 |
$1K |
| 93975 |
|
13 |
13 |
$690.15 |
| 71046 |
Radiologic examination, chest; 2 views |
73 |
70 |
$474.88 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
12 |
12 |
$430.70 |
| 70450 |
Computed tomography, head or brain; without contrast material |
12 |
12 |
$267.87 |
| 76536 |
|
12 |
12 |
$231.47 |
| 71045 |
Radiologic examination, chest; single view |
31 |
28 |
$143.10 |