| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
718 |
690 |
$46K |
| 36902 |
|
318 |
295 |
$22K |
| 71046 |
Radiologic examination, chest; 2 views |
1,307 |
1,219 |
$7K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
122 |
116 |
$6K |
| 71045 |
Radiologic examination, chest; single view |
1,370 |
1,198 |
$5K |
| 36215 |
|
49 |
42 |
$4K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
34 |
32 |
$4K |
| 99152 |
|
587 |
486 |
$3K |
| 76937 |
|
392 |
325 |
$2K |
| 36901 |
|
53 |
53 |
$2K |
| 36581 |
|
26 |
24 |
$1K |
| 37248 |
|
14 |
12 |
$1K |
| 75710 |
|
31 |
29 |
$732.50 |
| 93986 |
|
12 |
12 |
$652.65 |
| 93970 |
|
42 |
38 |
$577.82 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$505.40 |
| 77001 |
|
80 |
70 |
$493.81 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$207.74 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
44 |
39 |
$28.05 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
56 |
42 |
$18.09 |
| J2250 |
Injection, midazolam hydrochloride, per 1 mg |
93 |
77 |
$9.67 |