| Code | Description | Claims | Beneficiaries | Total Paid |
| 70450 |
Computed tomography, head or brain; without contrast material |
582 |
554 |
$19K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
214 |
213 |
$13K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
173 |
173 |
$10K |
| 71045 |
Radiologic examination, chest; single view |
1,332 |
1,273 |
$8K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
58 |
57 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
230 |
227 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
52 |
52 |
$2K |
| 70553 |
Magnetic resonance imaging, brain; without contrast material, followed by contrast material and further sequences |
25 |
25 |
$1K |
| 70496 |
|
12 |
12 |
$787.29 |
| 73630 |
|
42 |
40 |
$266.35 |
| 73030 |
|
29 |
29 |
$231.38 |