| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
490 |
456 |
$19K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
373 |
354 |
$12K |
| 70450 |
Computed tomography, head or brain; without contrast material |
726 |
670 |
$11K |
| 71046 |
Radiologic examination, chest; 2 views |
1,666 |
1,454 |
$7K |
| 71045 |
Radiologic examination, chest; single view |
768 |
614 |
$2K |
| 72125 |
Computed tomography, cervical spine; without contrast material |
77 |
70 |
$2K |
| 73564 |
|
150 |
124 |
$789.08 |
| 73630 |
|
152 |
126 |
$766.42 |
| 72110 |
|
74 |
72 |
$537.31 |
| 73610 |
|
120 |
104 |
$533.97 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
13 |
12 |
$442.53 |
| 73130 |
|
80 |
66 |
$353.03 |
| 73030 |
|
74 |
62 |
$274.94 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
16 |
15 |
$215.57 |
| 73502 |
|
56 |
53 |
$201.88 |
| 74018 |
|
28 |
26 |
$170.04 |
| 73110 |
|
29 |
26 |
$121.01 |