| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
473 |
427 |
$31K |
| 71045 |
Radiologic examination, chest; single view |
4,037 |
3,439 |
$25K |
| 70450 |
Computed tomography, head or brain; without contrast material |
366 |
335 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
489 |
361 |
$3K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
53 |
41 |
$1K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
29 |
26 |
$1K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
24 |
24 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
13 |
$959.29 |