| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
97 |
97 |
$6K |
| 70450 |
Computed tomography, head or brain; without contrast material |
101 |
100 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
395 |
385 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
24 |
24 |
$850.77 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
12 |
$556.05 |
| 72131 |
|
13 |
13 |
$470.66 |
| 72128 |
|
13 |
13 |
$415.12 |
| 71046 |
Radiologic examination, chest; 2 views |
44 |
44 |
$364.29 |
| 73030 |
|
14 |
14 |
$111.12 |
| 73610 |
|
13 |
13 |
$100.06 |
| 73630 |
|
13 |
13 |
$91.43 |