| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
304 |
292 |
$20K |
| 70450 |
Computed tomography, head or brain; without contrast material |
328 |
317 |
$15K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
85 |
84 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
27 |
26 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
49 |
46 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
198 |
185 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
76 |
74 |
$567.82 |