| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
264 |
262 |
$20K |
| 74178 |
|
154 |
154 |
$12K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
199 |
198 |
$9K |
| 71045 |
Radiologic examination, chest; single view |
700 |
557 |
$2K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
37 |
37 |
$1K |
| 71250 |
|
24 |
24 |
$1K |
| 74018 |
|
54 |
42 |
$418.18 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$297.42 |
| 93970 |
|
12 |
12 |
$291.07 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
51 |
51 |
$4.08 |