| Code | Description | Claims | Beneficiaries | Total Paid |
| 71046 |
Radiologic examination, chest; 2 views |
1,307 |
1,286 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
1,764 |
1,599 |
$4K |
| 70450 |
Computed tomography, head or brain; without contrast material |
256 |
256 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
39 |
39 |
$683.05 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
18 |
18 |
$389.12 |
| 73610 |
|
13 |
13 |
$84.73 |
| 73630 |
|
13 |
13 |
$47.67 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
1,173 |
1,149 |
$0.00 |