| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
102 |
98 |
$11K |
| 71046 |
Radiologic examination, chest; 2 views |
594 |
466 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
842 |
657 |
$6K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
47 |
33 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
103 |
97 |
$4K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
44 |
44 |
$4K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
55 |
53 |
$3K |
| 76770 |
|
15 |
14 |
$1K |
| 74018 |
|
167 |
128 |
$1K |
| 73130 |
|
46 |
37 |
$931.59 |
| 73630 |
|
48 |
41 |
$861.00 |
| 72110 |
|
18 |
18 |
$806.00 |
| 76830 |
Ultrasound, transvaginal |
15 |
14 |
$732.08 |
| 73030 |
|
13 |
13 |
$274.79 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
13 |
13 |
$86.40 |
| 99053 |
|
96 |
92 |
$0.00 |