| Code | Description | Claims | Beneficiaries | Total Paid |
| 70450 |
Computed tomography, head or brain; without contrast material |
1,987 |
1,822 |
$18K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
200 |
199 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
466 |
420 |
$926.95 |
| 72131 |
|
53 |
53 |
$333.93 |
| 72132 |
|
12 |
12 |
$204.13 |
| 71046 |
Radiologic examination, chest; 2 views |
59 |
59 |
$197.28 |
| 72100 |
|
15 |
15 |
$62.22 |
| 73502 |
|
13 |
13 |
$22.76 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
552 |
384 |
$0.00 |