| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
76 |
75 |
$5K |
| 71250 |
|
41 |
40 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
245 |
225 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
42 |
42 |
$866.54 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
16 |
16 |
$520.29 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$494.07 |
| 74018 |
|
54 |
47 |
$326.26 |
| 71046 |
Radiologic examination, chest; 2 views |
28 |
28 |
$180.45 |