| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
1,608 |
1,472 |
$92K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
864 |
846 |
$36K |
| 71045 |
Radiologic examination, chest; single view |
2,906 |
2,639 |
$11K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
103 |
100 |
$9K |
| 71046 |
Radiologic examination, chest; 2 views |
497 |
484 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
73 |
71 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
17 |
17 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
20 |
18 |
$779.95 |
| 74018 |
|
62 |
54 |
$286.10 |
| 99072 |
|
32 |
32 |
$0.00 |
| 92015 |
Determination of refractive state |
41 |
41 |
$0.00 |