| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
138 |
137 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
1,019 |
969 |
$6K |
| 70450 |
Computed tomography, head or brain; without contrast material |
176 |
175 |
$5K |
| 73630 |
|
240 |
230 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
61 |
60 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
25 |
25 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
174 |
172 |
$1K |
| 73610 |
|
139 |
131 |
$1K |
| 73721 |
Magnetic resonance imaging, any joint of lower extremity; without contrast material |
15 |
15 |
$986.30 |
| 71250 |
|
12 |
12 |
$638.76 |
| 73030 |
|
61 |
59 |
$515.26 |
| 73130 |
|
41 |
40 |
$379.52 |
| 76536 |
|
12 |
12 |
$312.16 |
| 71271 |
|
12 |
12 |
$228.85 |
| 73110 |
|
12 |
12 |
$117.16 |
| 74018 |
|
12 |
12 |
$76.60 |