| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
252 |
219 |
$15K |
| 70450 |
Computed tomography, head or brain; without contrast material |
405 |
342 |
$11K |
| 71046 |
Radiologic examination, chest; 2 views |
1,178 |
1,008 |
$9K |
| 71045 |
Radiologic examination, chest; single view |
1,075 |
699 |
$6K |
| 74018 |
|
564 |
437 |
$4K |
| 73610 |
|
185 |
159 |
$1K |
| 73564 |
|
145 |
123 |
$1K |
| 73630 |
|
160 |
142 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
55 |
43 |
$1K |
| 73110 |
|
60 |
54 |
$419.73 |
| 73130 |
|
49 |
45 |
$337.43 |
| 73030 |
|
48 |
44 |
$308.16 |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
19 |
12 |
$279.84 |
| 74022 |
|
12 |
12 |
$166.76 |
| 72100 |
|
13 |
13 |
$126.36 |
| 74019 |
|
13 |
13 |
$116.16 |
| 73560 |
|
19 |
12 |
$90.53 |