| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
116 |
102 |
$4K |
| 70486 |
|
14 |
12 |
$2K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
17 |
17 |
$2K |
| 76536 |
|
12 |
12 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
219 |
128 |
$1K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13 |
12 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
185 |
106 |
$1K |
| 74018 |
|
54 |
35 |
$244.82 |
| 73610 |
|
20 |
17 |
$182.60 |
| 73130 |
|
13 |
13 |
$158.35 |
| 99053 |
|
72 |
62 |
$0.00 |