| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
34 |
34 |
$388.74 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
36 |
34 |
$388.74 |
| 80053 |
Comprehensive metabolic panel |
70 |
68 |
$218.64 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
28 |
28 |
$187.54 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
24 |
24 |
$184.14 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
65 |
62 |
$124.05 |
| 87563 |
|
22 |
22 |
$122.76 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
33 |
33 |
$102.30 |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
31 |
31 |
$81.86 |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
16 |
14 |
$76.00 |
| 86803 |
|
15 |
15 |
$68.17 |
| 87340 |
|
19 |
19 |
$62.35 |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
21 |
21 |
$61.80 |
| 86706 |
|
13 |
13 |
$51.29 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
23 |
23 |
$43.16 |
| 87799 |
|
15 |
14 |
$40.00 |
| 82607 |
|
15 |
13 |
$35.16 |
| 80061 |
Lipid panel |
27 |
22 |
$31.24 |
| 87077 |
|
13 |
13 |
$22.84 |
| 81001 |
|
31 |
31 |
$22.20 |
| 86592 |
|
19 |
19 |
$20.92 |
| 84443 |
Thyroid stimulating hormone (TSH) |
27 |
23 |
$19.60 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
19 |
16 |
$17.26 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
28 |
24 |
$13.50 |
| 84439 |
|
15 |
14 |
$10.52 |
| 36415 |
Collection of venous blood by venipuncture |
32 |
32 |
$2.70 |
| 87481 |
|
22 |
22 |
$0.00 |
| 87512 |
|
14 |
14 |
$0.00 |