| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
1,130 |
1,044 |
$67K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
620 |
602 |
$26K |
| 71045 |
Radiologic examination, chest; single view |
3,542 |
2,996 |
$14K |
| 71046 |
Radiologic examination, chest; 2 views |
1,168 |
1,109 |
$7K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
36 |
32 |
$1K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
12 |
12 |
$837.08 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
12 |
12 |
$533.61 |
| 73564 |
|
27 |
24 |
$444.96 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$265.89 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
13 |
$187.60 |
| 73610 |
|
13 |
13 |
$186.55 |