| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71046 |
Radiologic examination, chest; 2 views |
167 |
141 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
21 |
16 |
$577.06 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
16 |
14 |
$568.49 |
| 70450 |
Computed tomography, head or brain; without contrast material |
16 |
13 |
$444.78 |
| 71045 |
Radiologic examination, chest; single view |
80 |
58 |
$377.30 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
18 |
13 |
$281.42 |
| 73564 |
|
26 |
15 |
$136.92 |
| 74019 |
|
15 |
12 |
$108.02 |