| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,199 |
1,061 |
$45K |
| 70450 |
Computed tomography, head or brain; without contrast material |
2,925 |
2,507 |
$34K |
| 71045 |
Radiologic examination, chest; single view |
11,228 |
8,304 |
$23K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
827 |
742 |
$23K |
| 71046 |
Radiologic examination, chest; 2 views |
2,967 |
2,617 |
$13K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
267 |
231 |
$8K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
265 |
229 |
$5K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
154 |
138 |
$2K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
85 |
59 |
$2K |
| 74018 |
|
370 |
318 |
$2K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
108 |
85 |
$1K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
95 |
81 |
$847.20 |
| 73630 |
|
152 |
128 |
$660.16 |
| 73610 |
|
69 |
59 |
$268.00 |
| 93971 |
|
14 |
13 |
$132.44 |
| 73130 |
|
12 |
12 |
$60.11 |
| 93970 |
|
12 |
12 |
$57.43 |
| 76937 |
|
18 |
16 |
$16.50 |
| 77001 |
|
13 |
12 |
$0.00 |