| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
358 |
356 |
$12K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
65 |
65 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
526 |
526 |
$4K |
| 76830 |
Ultrasound, transvaginal |
157 |
156 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
173 |
170 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
142 |
142 |
$3K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
57 |
57 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
30 |
30 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
71 |
70 |
$2K |
| 93976 |
|
54 |
54 |
$2K |
| 76376 |
|
190 |
190 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
192 |
183 |
$1K |
| 73630 |
|
186 |
172 |
$1K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
41 |
41 |
$1K |
| 70450 |
Computed tomography, head or brain; without contrast material |
28 |
28 |
$813.50 |
| 93975 |
|
17 |
17 |
$747.83 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
12 |
$219.12 |
| 93971 |
|
13 |
13 |
$208.80 |
| 73610 |
|
25 |
25 |
$164.82 |
| 73564 |
|
12 |
12 |
$122.78 |
| 73030 |
|
13 |
13 |
$95.42 |
| 73110 |
|
13 |
12 |
$88.14 |
| 73562 |
|
12 |
12 |
$82.72 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
37 |
35 |
$0.00 |