| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
43 |
43 |
$972.01 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
13 |
$415.27 |
| 71046 |
Radiologic examination, chest; 2 views |
43 |
43 |
$331.92 |
| 70450 |
Computed tomography, head or brain; without contrast material |
17 |
16 |
$241.60 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
171 |
138 |
$0.00 |