| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
1,079 |
1,066 |
$12K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
355 |
355 |
$12K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$394.28 |
| 71045 |
Radiologic examination, chest; single view |
69 |
62 |
$219.90 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
12 |
12 |
$144.12 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$105.59 |