| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
42 |
41 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
81 |
78 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
273 |
264 |
$1K |
| 72148 |
Magnetic resonance imaging, lumbar spine; without contrast material |
17 |
16 |
$999.29 |
| 71046 |
Radiologic examination, chest; 2 views |
104 |
98 |
$545.58 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
13 |
12 |
$55.54 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
12 |
$0.00 |