| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,080 |
1,064 |
$73K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
310 |
300 |
$18K |
| 93975 |
|
44 |
43 |
$3K |
| 74018 |
|
101 |
95 |
$730.89 |
| 76830 |
Ultrasound, transvaginal |
26 |
26 |
$602.94 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
15 |
15 |
$475.35 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$282.08 |
| 71045 |
Radiologic examination, chest; single view |
30 |
27 |
$210.86 |
| 71046 |
Radiologic examination, chest; 2 views |
17 |
17 |
$197.05 |
| 76857 |
|
13 |
13 |
$171.60 |