| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 71046 |
Radiologic examination, chest; 2 views |
2,241 |
2,209 |
$23K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
266 |
264 |
$23K |
| 71045 |
Radiologic examination, chest; single view |
2,502 |
2,052 |
$15K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
202 |
199 |
$12K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
500 |
493 |
$11K |
| 71250 |
|
114 |
113 |
$5K |
| 73630 |
|
468 |
450 |
$5K |
| 70450 |
Computed tomography, head or brain; without contrast material |
131 |
128 |
$5K |
| 76536 |
|
187 |
186 |
$5K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
44 |
44 |
$4K |
| 74018 |
|
316 |
304 |
$3K |
| 73610 |
|
121 |
116 |
$2K |
| 71271 |
|
27 |
27 |
$595.01 |
| 76770 |
|
12 |
12 |
$317.11 |
| 73502 |
|
26 |
24 |
$310.26 |
| 73030 |
|
15 |
14 |
$204.89 |
| 73590 |
|
13 |
13 |
$136.63 |
| 73110 |
|
12 |
12 |
$122.03 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
44 |
42 |
$0.00 |