| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
66 |
52 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
110 |
81 |
$799.28 |
| 71020 |
|
66 |
50 |
$237.02 |
| 71046 |
Radiologic examination, chest; 2 views |
206 |
199 |
$214.54 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
37 |
37 |
$175.92 |
| 71045 |
Radiologic examination, chest; single view |
113 |
109 |
$166.21 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
16 |
12 |
$139.92 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
14 |
14 |
$120.69 |
| 73130 |
|
12 |
12 |
$52.06 |
| 74022 |
|
13 |
13 |
$24.84 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
13 |
13 |
$20.10 |
| 73562 |
|
12 |
12 |
$16.31 |
| 73030 |
|
15 |
13 |
$8.48 |
| 73610 |
|
12 |
12 |
$6.72 |
| 73630 |
|
13 |
12 |
$6.71 |
| 73140 |
|
13 |
13 |
$5.88 |