| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
320 |
318 |
$28K |
| 70450 |
Computed tomography, head or brain; without contrast material |
440 |
432 |
$19K |
| 71045 |
Radiologic examination, chest; single view |
1,904 |
1,722 |
$19K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12 |
12 |
$998.85 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
52 |
52 |
$914.59 |
| 76830 |
Ultrasound, transvaginal |
38 |
38 |
$756.68 |
| 71046 |
Radiologic examination, chest; 2 views |
26 |
26 |
$307.90 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
14 |
13 |
$250.46 |
| 99053 |
|
572 |
545 |
$0.00 |