| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
167 |
159 |
$15K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
50 |
49 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
607 |
457 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
92 |
88 |
$4K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
28 |
28 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
235 |
199 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$2K |
| 76801 |
|
12 |
12 |
$608.04 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$600.49 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
16 |
16 |
$564.31 |
| 74018 |
|
22 |
15 |
$112.00 |
| 99053 |
|
130 |
121 |
$0.00 |