| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
624 |
620 |
$37K |
| 71250 |
|
262 |
261 |
$10K |
| 71045 |
Radiologic examination, chest; single view |
1,527 |
1,418 |
$9K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
156 |
155 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
879 |
868 |
$7K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
190 |
189 |
$4K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
13 |
13 |
$4K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
85 |
84 |
$3K |
| 70450 |
Computed tomography, head or brain; without contrast material |
84 |
82 |
$2K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
27 |
27 |
$2K |
| 71271 |
|
27 |
26 |
$961.17 |
| 76536 |
|
24 |
24 |
$572.33 |
| 74018 |
|
31 |
30 |
$175.13 |