| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
54 |
54 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
489 |
424 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
87 |
87 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
238 |
233 |
$1K |
| 73630 |
|
54 |
47 |
$577.91 |
| 73110 |
|
22 |
15 |
$277.50 |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
30 |
30 |
$185.87 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$127.20 |
| 72141 |
|
14 |
14 |
$28.48 |