| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
101 |
97 |
$6K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
29 |
28 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
71 |
67 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
359 |
330 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
181 |
179 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
27 |
25 |
$660.06 |
| 73630 |
|
13 |
12 |
$161.57 |
| 76937 |
|
20 |
20 |
$97.74 |