| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71250 |
|
578 |
534 |
$48K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
156 |
133 |
$20K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
144 |
123 |
$19K |
| 76830 |
Ultrasound, transvaginal |
157 |
155 |
$15K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
129 |
127 |
$9K |
| 71046 |
Radiologic examination, chest; 2 views |
494 |
477 |
$8K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
32 |
24 |
$5K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
888 |
669 |
$3K |
| A9577 |
Injection, gadobenate dimeglumine (multihance), per ml |
378 |
264 |
$3K |