| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
779 |
668 |
$56K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
362 |
338 |
$17K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
354 |
304 |
$14K |
| 71046 |
Radiologic examination, chest; 2 views |
1,218 |
1,134 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
1,234 |
1,085 |
$6K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
116 |
108 |
$4K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
148 |
119 |
$3K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
52 |
43 |
$2K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
57 |
52 |
$2K |
| 73630 |
|
134 |
123 |
$1K |
| 93976 |
|
41 |
37 |
$808.08 |
| 73030 |
|
62 |
50 |
$802.85 |
| 73610 |
|
38 |
33 |
$588.35 |
| 73130 |
|
63 |
59 |
$550.72 |
| 73562 |
|
36 |
30 |
$393.36 |
| 70486 |
|
14 |
13 |
$340.14 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
13 |
12 |
$276.09 |
| 76819 |
Fetal biophysical profile; without non-stress testing |
17 |
15 |
$252.85 |
| 73110 |
|
15 |
12 |
$179.50 |
| 99053 |
|
544 |
487 |
$0.00 |