| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
382 |
367 |
$21K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
253 |
251 |
$9K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
229 |
226 |
$9K |
| 71045 |
Radiologic examination, chest; single view |
2,105 |
1,821 |
$8K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
53 |
52 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
603 |
553 |
$4K |
| 73630 |
|
225 |
211 |
$2K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
37 |
37 |
$1K |
| 73610 |
|
85 |
82 |
$1K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
33 |
31 |
$1K |
| 71250 |
|
44 |
40 |
$1K |
| 73130 |
|
80 |
72 |
$740.74 |
| 72100 |
|
64 |
63 |
$670.00 |
| 73030 |
|
71 |
66 |
$618.84 |
| 74018 |
|
74 |
66 |
$417.77 |
| 73110 |
|
32 |
31 |
$312.66 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
15 |
13 |
$277.16 |
| 73562 |
|
27 |
26 |
$244.47 |
| 73560 |
|
30 |
28 |
$221.70 |
| 93971 |
|
17 |
17 |
$134.90 |
| 73502 |
|
17 |
17 |
$99.24 |