| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
923 |
902 |
$25K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
283 |
280 |
$5K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
69 |
69 |
$1K |
| 76770 |
|
15 |
15 |
$415.94 |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
12 |
12 |
$356.51 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
15 |
14 |
$156.92 |
| 71250 |
|
12 |
12 |
$52.44 |