| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
724 |
690 |
$26K |
| 70450 |
Computed tomography, head or brain; without contrast material |
104 |
100 |
$7K |
| 71275 |
Computed tomographic angiography, chest, with contrast material |
40 |
40 |
$4K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
49 |
45 |
$2K |
| 71045 |
Radiologic examination, chest; single view |
292 |
243 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
90 |
89 |
$402.42 |
| 72125 |
Computed tomography, cervical spine; without contrast material |
12 |
12 |
$305.82 |
| 72100 |
|
12 |
12 |
$135.91 |
| 73030 |
|
14 |
14 |
$135.55 |
| G9637 |
Final reports with documentation of one or more dose reduction techniques (e.g., automated exposure control, adjustment of the ma and/or kv according to patient size, use of iterative reconstruction technique) |
130 |
103 |
$0.00 |