| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
314 |
308 |
$13K |
| 71045 |
Radiologic examination, chest; single view |
853 |
748 |
$3K |
| 76770 |
|
138 |
138 |
$2K |
| 93970 |
|
146 |
146 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
115 |
112 |
$2K |
| 74176 |
Computed tomography, abdomen and pelvis; without contrast material |
55 |
54 |
$1K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
28 |
28 |
$536.00 |
| 71046 |
Radiologic examination, chest; 2 views |
115 |
114 |
$527.51 |
| 76775 |
|
24 |
24 |
$284.62 |
| 74230 |
|
12 |
12 |
$29.90 |