| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
207 |
202 |
$11K |
| 70450 |
Computed tomography, head or brain; without contrast material |
198 |
195 |
$11K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
47 |
47 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
693 |
644 |
$4K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
29 |
29 |
$1K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
17 |
17 |
$707.95 |
| 71046 |
Radiologic examination, chest; 2 views |
105 |
103 |
$691.37 |
| 73562 |
|
32 |
29 |
$403.40 |
| 73130 |
|
28 |
25 |
$289.97 |
| 73630 |
|
14 |
13 |
$183.35 |
| 73090 |
|
12 |
12 |
$117.72 |