| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
171 |
168 |
$19K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
57 |
57 |
$11K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
91 |
91 |
$10K |
| 71046 |
Radiologic examination, chest; 2 views |
420 |
420 |
$9K |
| 71250 |
|
64 |
64 |
$7K |
| 73630 |
|
60 |
52 |
$2K |
| 73562 |
|
28 |
24 |
$893.23 |
| 73610 |
|
30 |
28 |
$882.06 |
| 73030 |
|
26 |
24 |
$738.32 |
| 73110 |
|
13 |
13 |
$391.59 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
29 |
28 |
$0.00 |