| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
193 |
192 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
1,063 |
969 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
91 |
90 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
12 |
12 |
$552.34 |
| 93975 |
|
15 |
14 |
$498.58 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
16 |
16 |
$345.24 |
| 71046 |
Radiologic examination, chest; 2 views |
74 |
71 |
$310.05 |
| 71250 |
|
45 |
42 |
$256.47 |