| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
79 |
75 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
400 |
275 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
28 |
25 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
16 |
16 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
213 |
149 |
$2K |
| 73630 |
|
55 |
41 |
$1K |
| 74018 |
|
92 |
73 |
$757.70 |
| 70450 |
Computed tomography, head or brain; without contrast material |
16 |
14 |
$525.36 |
| 73130 |
|
20 |
16 |
$521.90 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
15 |
12 |
$105.80 |
| 99053 |
|
57 |
55 |
$0.00 |