| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
354 |
337 |
$17K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
80 |
69 |
$8K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
33 |
27 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
14 |
13 |
$716.74 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
17 |
12 |
$319.22 |
| 71045 |
Radiologic examination, chest; single view |
30 |
29 |
$158.59 |