| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
237 |
230 |
$8K |
| 73564 |
|
414 |
385 |
$5K |
| 71045 |
Radiologic examination, chest; single view |
698 |
650 |
$2K |
| 73562 |
|
59 |
52 |
$675.81 |
| 73030 |
|
72 |
68 |
$630.94 |
| 71046 |
Radiologic examination, chest; 2 views |
144 |
143 |
$630.65 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
29 |
29 |
$421.06 |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$316.92 |
| 76770 |
|
12 |
12 |
$265.13 |
| 73502 |
|
45 |
44 |
$231.83 |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
13 |
13 |
$204.50 |
| 73560 |
|
17 |
17 |
$159.69 |