| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 72125 |
Computed tomography, cervical spine; without contrast material |
233 |
232 |
$11K |
| 72131 |
|
141 |
141 |
$7K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
112 |
112 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
1,159 |
915 |
$7K |
| 72128 |
|
125 |
125 |
$6K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
55 |
54 |
$4K |
| 73630 |
|
467 |
456 |
$3K |
| 73610 |
|
315 |
298 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
163 |
163 |
$1K |
| 73590 |
|
136 |
134 |
$1K |
| 73560 |
|
101 |
97 |
$906.63 |
| 73130 |
|
115 |
114 |
$880.60 |
| 73502 |
|
104 |
103 |
$798.66 |
| 73030 |
|
92 |
90 |
$749.36 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$540.04 |
| 72100 |
|
46 |
46 |
$471.83 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
12 |
12 |
$447.67 |
| 73552 |
|
58 |
56 |
$421.66 |
| 71250 |
|
13 |
13 |
$398.92 |
| 73110 |
|
48 |
46 |
$374.64 |
| 73564 |
|
35 |
35 |
$352.69 |
| 72170 |
|
32 |
32 |
$233.84 |
| 73562 |
|
18 |
18 |
$155.47 |
| 74018 |
|
17 |
15 |
$92.91 |