| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
194 |
193 |
$17K |
| 70450 |
Computed tomography, head or brain; without contrast material |
347 |
339 |
$15K |
| 71045 |
Radiologic examination, chest; single view |
1,045 |
946 |
$11K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
13 |
13 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
18 |
18 |
$252.51 |
| 76830 |
Ultrasound, transvaginal |
17 |
17 |
$228.00 |
| 71046 |
Radiologic examination, chest; 2 views |
16 |
15 |
$161.50 |
| 99053 |
|
516 |
501 |
$0.00 |