| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71046 |
Radiologic examination, chest; 2 views |
758 |
755 |
$6K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
56 |
56 |
$4K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
50 |
50 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
343 |
307 |
$2K |
| 71250 |
|
24 |
24 |
$916.06 |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
12 |
12 |
$770.00 |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
24 |
24 |
$752.33 |
| 70450 |
Computed tomography, head or brain; without contrast material |
14 |
14 |
$419.66 |