| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
87 |
85 |
$7K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
66 |
65 |
$3K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
12 |
12 |
$1K |
| 71045 |
Radiologic examination, chest; single view |
197 |
177 |
$996.10 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
20 |
20 |
$810.78 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
14 |
14 |
$670.95 |
| 71046 |
Radiologic examination, chest; 2 views |
50 |
50 |
$325.63 |
| 73630 |
|
14 |
14 |
$150.50 |