| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
228 |
226 |
$13K |
| 70450 |
Computed tomography, head or brain; without contrast material |
433 |
419 |
$11K |
| 71045 |
Radiologic examination, chest; single view |
1,912 |
1,721 |
$9K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
164 |
159 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
732 |
709 |
$4K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
112 |
112 |
$2K |
| 71250 |
|
26 |
26 |
$919.59 |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
12 |
12 |
$854.78 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
39 |
39 |
$699.41 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$462.92 |
| 76536 |
|
25 |
25 |
$309.81 |
| 73564 |
|
13 |
13 |
$135.11 |
| 73630 |
|
16 |
16 |
$129.00 |
| 73610 |
|
13 |
13 |
$128.64 |