| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
296 |
257 |
$19K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
184 |
171 |
$8K |
| 71045 |
Radiologic examination, chest; single view |
468 |
428 |
$2K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
19 |
13 |
$2K |
| 71046 |
Radiologic examination, chest; 2 views |
224 |
207 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
31 |
30 |
$913.88 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
12 |
12 |
$555.94 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
17 |
12 |
$504.11 |
| 73630 |
|
12 |
12 |
$119.96 |
| 74018 |
|
19 |
17 |
$84.58 |