| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
109 |
99 |
$9K |
| 71046 |
Radiologic examination, chest; 2 views |
342 |
316 |
$3K |
| 70450 |
Computed tomography, head or brain; without contrast material |
107 |
83 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
347 |
255 |
$2K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
42 |
42 |
$2K |
| 76830 |
Ultrasound, transvaginal |
38 |
38 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
27 |
27 |
$1K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$403.20 |