| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
959 |
933 |
$73K |
| 76830 |
Ultrasound, transvaginal |
290 |
282 |
$16K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
280 |
274 |
$14K |
| 70450 |
Computed tomography, head or brain; without contrast material |
409 |
402 |
$11K |
| 72197 |
|
12 |
12 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
972 |
957 |
$7K |
| 76536 |
|
101 |
96 |
$6K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
126 |
124 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
56 |
55 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
641 |
582 |
$3K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
127 |
124 |
$3K |
| 93975 |
|
25 |
24 |
$3K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
52 |
51 |
$2K |
| 70496 |
|
25 |
25 |
$1K |
| 70498 |
|
29 |
29 |
$1K |
| A9575 |
Injection, gadoterate meglumine, 0.1 ml |
50 |
21 |
$1K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
13 |
13 |
$913.00 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
15 |
15 |
$747.95 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
16 |
15 |
$329.89 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
17 |
17 |
$321.58 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
19 |
15 |
$256.17 |
| 73610 |
|
28 |
26 |
$152.82 |
| 73130 |
|
16 |
15 |
$97.38 |
| 73630 |
|
17 |
16 |
$97.33 |