| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70496 |
|
60 |
43 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
173 |
139 |
$4K |
| 70498 |
|
61 |
44 |
$3K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
78 |
63 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
311 |
225 |
$2K |
| 70486 |
|
28 |
24 |
$1K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
19 |
16 |
$1K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
16 |
13 |
$387.00 |
| 71046 |
Radiologic examination, chest; 2 views |
33 |
29 |
$151.24 |