| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
620 |
561 |
$36K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
310 |
292 |
$14K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
114 |
107 |
$11K |
| 71045 |
Radiologic examination, chest; single view |
1,230 |
1,018 |
$5K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
122 |
121 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
638 |
581 |
$4K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
96 |
86 |
$4K |
| 73630 |
|
140 |
137 |
$1K |
| 73610 |
|
63 |
63 |
$823.31 |
| 71250 |
|
32 |
31 |
$652.60 |
| 70486 |
|
13 |
13 |
$575.46 |
| 72131 |
|
14 |
14 |
$439.89 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
15 |
15 |
$435.93 |
| 73110 |
|
25 |
24 |
$224.49 |
| 74018 |
|
58 |
52 |
$208.02 |
| 73130 |
|
27 |
24 |
$194.18 |
| 73030 |
|
15 |
13 |
$127.89 |
| 73564 |
|
16 |
14 |
$112.82 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
14 |
13 |
$0.00 |