| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
104 |
103 |
$6K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
107 |
103 |
$5K |
| 76770 |
|
85 |
74 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
581 |
572 |
$3K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
24 |
24 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
300 |
279 |
$1K |
| 99152 |
|
167 |
145 |
$662.61 |
| 73564 |
|
41 |
41 |
$473.64 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
26 |
26 |
$447.72 |
| 72100 |
|
16 |
15 |
$193.29 |
| 73030 |
|
13 |
13 |
$113.99 |