| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 71045 |
Radiologic examination, chest; single view |
296 |
260 |
$3K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
31 |
31 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
20 |
20 |
$697.81 |
| 93976 |
|
15 |
15 |
$574.69 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$455.72 |
| 76830 |
Ultrasound, transvaginal |
12 |
12 |
$257.79 |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
12 |
12 |
$232.44 |