| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
153 |
152 |
$9K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
76 |
73 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
120 |
115 |
$4K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
14 |
14 |
$1K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
25 |
25 |
$774.56 |
| 71045 |
Radiologic examination, chest; single view |
17 |
15 |
$95.05 |
| 99053 |
|
16 |
13 |
$0.00 |