| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
633 |
623 |
$36K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
179 |
177 |
$10K |
| 71045 |
Radiologic examination, chest; single view |
1,528 |
1,360 |
$9K |
| 71250 |
|
238 |
235 |
$9K |
| 71046 |
Radiologic examination, chest; 2 views |
883 |
875 |
$7K |
| 71260 |
Computed tomography, thorax, diagnostic; with contrast material |
139 |
139 |
$6K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
119 |
118 |
$3K |
| 70450 |
Computed tomography, head or brain; without contrast material |
40 |
40 |
$1K |
| 78815 |
Positron emission tomography (PET) for limited area imaging |
12 |
12 |
$1K |
| 70551 |
Magnetic resonance imaging, brain; without contrast material |
25 |
24 |
$1K |
| 76536 |
|
31 |
31 |
$622.73 |
| 73630 |
|
88 |
84 |
$613.19 |
| 76770 |
|
12 |
12 |
$372.36 |
| 73030 |
|
12 |
12 |
$110.80 |
| 73610 |
|
12 |
12 |
$100.56 |
| 73562 |
|
15 |
12 |
$70.07 |