| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71046 |
Radiologic examination, chest; 2 views |
697 |
660 |
$6K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
64 |
62 |
$5K |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
365 |
277 |
$3K |
| 76801 |
|
39 |
38 |
$2K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12 |
12 |
$1K |
| 73630 |
|
105 |
84 |
$930.95 |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
16 |
15 |
$695.40 |
| 93970 |
|
12 |
12 |
$660.72 |
| A9579 |
Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml |
44 |
29 |
$322.57 |