| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
125 |
118 |
$4K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
30 |
29 |
$3K |
| 76830 |
Ultrasound, transvaginal |
34 |
27 |
$1K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
13 |
13 |
$857.18 |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12 |
12 |
$674.46 |
| 93975 |
|
17 |
13 |
$623.89 |
| 71045 |
Radiologic examination, chest; single view |
107 |
102 |
$546.14 |
| 71046 |
Radiologic examination, chest; 2 views |
64 |
64 |
$436.85 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$401.98 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$377.49 |
| 72100 |
|
13 |
13 |
$186.16 |
| 74018 |
|
13 |
13 |
$56.85 |