| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
273 |
271 |
$20K |
| 70450 |
Computed tomography, head or brain; without contrast material |
419 |
414 |
$16K |
| 71045 |
Radiologic examination, chest; single view |
1,234 |
1,206 |
$9K |
| 71046 |
Radiologic examination, chest; 2 views |
542 |
536 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
15 |
15 |
$985.01 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$543.89 |
| 73630 |
|
13 |
12 |
$107.25 |
| 73610 |
|
12 |
12 |
$97.24 |