| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
166 |
164 |
$16K |
| 70450 |
Computed tomography, head or brain; without contrast material |
170 |
166 |
$12K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
102 |
101 |
$10K |
| 71045 |
Radiologic examination, chest; single view |
814 |
705 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
185 |
175 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$944.00 |
| 74018 |
|
14 |
14 |
$133.08 |