| Code | Description | Claims | Beneficiaries | Total Paid |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
270 |
269 |
$14K |
| 70450 |
Computed tomography, head or brain; without contrast material |
566 |
555 |
$12K |
| 71046 |
Radiologic examination, chest; 2 views |
1,346 |
1,312 |
$11K |
| 71045 |
Radiologic examination, chest; single view |
717 |
690 |
$3K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
13 |
13 |
$693.00 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
24 |
24 |
$658.87 |
| 73564 |
|
13 |
12 |
$68.21 |