| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
43 |
41 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
326 |
315 |
$3K |
| 70450 |
Computed tomography, head or brain; without contrast material |
81 |
79 |
$3K |
| 71045 |
Radiologic examination, chest; single view |
339 |
267 |
$2K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
45 |
45 |
$1K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
19 |
18 |
$1K |
| 73630 |
|
43 |
39 |
$285.27 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
12 |
12 |
$269.28 |
| 73562 |
|
28 |
25 |
$211.44 |
| 73110 |
|
13 |
13 |
$94.22 |
| 74018 |
|
13 |
13 |
$91.13 |
| 73030 |
|
13 |
13 |
$87.24 |
| 73130 |
|
12 |
12 |
$80.76 |