| Code | Description | Claims | Beneficiaries | Total Paid |
| 76830 |
Ultrasound, transvaginal |
812 |
812 |
$48K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
650 |
650 |
$36K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
50 |
49 |
$3K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
13 |
13 |
$396.11 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$261.60 |
| 71046 |
Radiologic examination, chest; 2 views |
16 |
16 |
$135.08 |
| 71045 |
Radiologic examination, chest; single view |
17 |
14 |
$119.58 |