| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
181 |
179 |
$17K |
| 70450 |
Computed tomography, head or brain; without contrast material |
346 |
320 |
$15K |
| 71045 |
Radiologic examination, chest; single view |
1,199 |
845 |
$8K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
65 |
58 |
$5K |
| 71046 |
Radiologic examination, chest; 2 views |
524 |
401 |
$4K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
23 |
22 |
$3K |
| 74018 |
|
194 |
133 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
26 |
25 |
$853.17 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
14 |
13 |
$694.83 |
| 93970 |
|
13 |
13 |
$372.96 |
| 73630 |
|
13 |
13 |
$154.28 |
| 73610 |
|
14 |
12 |
$82.17 |
| 99053 |
|
181 |
162 |
$0.00 |