| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
113 |
112 |
$6K |
| 71046 |
Radiologic examination, chest; 2 views |
655 |
644 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
150 |
150 |
$4K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
78 |
78 |
$2K |
| 70450 |
Computed tomography, head or brain; without contrast material |
13 |
13 |
$467.80 |
| 74018 |
|
25 |
25 |
$143.50 |
| 73610 |
|
14 |
13 |
$93.70 |