| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
1,336 |
1,197 |
$79K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
282 |
247 |
$53K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
816 |
749 |
$32K |
| 70450 |
Computed tomography, head or brain; without contrast material |
978 |
884 |
$20K |
| 71046 |
Radiologic examination, chest; 2 views |
3,147 |
2,729 |
$20K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
770 |
701 |
$20K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
396 |
330 |
$11K |
| 71045 |
Radiologic examination, chest; single view |
1,357 |
1,006 |
$5K |
| 73610 |
|
669 |
583 |
$4K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
19 |
19 |
$4K |
| 73630 |
|
680 |
605 |
$3K |
| 73130 |
|
562 |
418 |
$3K |
| 73562 |
|
394 |
332 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
127 |
118 |
$2K |
| 72100 |
|
381 |
361 |
$2K |
| 73110 |
|
262 |
215 |
$2K |
| 73030 |
|
228 |
196 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
16 |
12 |
$730.73 |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
13 |
12 |
$642.07 |
| 74018 |
|
76 |
71 |
$526.89 |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
13 |
13 |
$412.75 |
| 73564 |
|
45 |
36 |
$408.68 |
| 73140 |
|
42 |
36 |
$199.46 |
| 73502 |
|
36 |
25 |
$178.12 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
13 |
13 |
$0.00 |