| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
616 |
590 |
$27K |
| 71045 |
Radiologic examination, chest; single view |
848 |
773 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
639 |
625 |
$4K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
14 |
14 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
12 |
12 |
$822.32 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
19 |
19 |
$668.58 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
12 |
12 |
$580.06 |
| 71250 |
|
12 |
12 |
$420.14 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
26 |
26 |
$405.08 |
| 73630 |
|
20 |
17 |
$232.15 |
| G1004 |
Clinical decision support mechanism national decision support company, as defined by the medicare appropriate use criteria program |
79 |
60 |
$0.00 |