| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
379 |
371 |
$25K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
258 |
250 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
728 |
702 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
673 |
606 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
40 |
39 |
$1K |
| 73630 |
|
15 |
14 |
$206.01 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
17 |
17 |
$151.80 |
| 73564 |
|
13 |
12 |
$108.68 |