| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
79 |
78 |
$7K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
58 |
55 |
$5K |
| 71046 |
Radiologic examination, chest; 2 views |
212 |
200 |
$801.36 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$637.41 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
13 |
$530.26 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
21 |
21 |
$481.85 |
| 71045 |
Radiologic examination, chest; single view |
141 |
127 |
$347.75 |
| 73030 |
|
26 |
25 |
$289.38 |
| 72100 |
|
17 |
17 |
$227.19 |
| 73630 |
|
17 |
14 |
$214.62 |
| 73610 |
|
13 |
13 |
$180.83 |
| 73560 |
|
13 |
13 |
$151.98 |
| 73562 |
|
15 |
15 |
$146.13 |