| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 70450 |
Computed tomography, head or brain; without contrast material |
166 |
152 |
$12K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
187 |
171 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
638 |
609 |
$4K |
| 71045 |
Radiologic examination, chest; single view |
535 |
468 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
28 |
26 |
$1K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
15 |
15 |
$635.28 |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
17 |
16 |
$380.28 |
| 74018 |
|
27 |
25 |
$125.81 |