| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
281,657 |
258,045 |
$18.31M |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
296,520 |
288,764 |
$5.07M |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
295,192 |
287,483 |
$4.80M |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
301,122 |
296,507 |
$4.02M |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
189,979 |
174,986 |
$3.97M |
| 80050 |
General health panel |
228,729 |
225,736 |
$3.43M |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
158,000 |
151,581 |
$2.42M |
| 80053 |
Comprehensive metabolic panel |
426,164 |
413,566 |
$2.18M |
| 80061 |
Lipid panel |
472,187 |
464,818 |
$2.17M |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
135,195 |
134,262 |
$2.08M |
| 86480 |
|
72,873 |
71,682 |
$2.07M |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
47,207 |
44,976 |
$2.04M |
| 86769 |
|
65,971 |
65,359 |
$2.00M |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
182,304 |
178,265 |
$1.93M |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
109,025 |
108,371 |
$1.92M |
| 83036 |
Hemoglobin; glycosylated (A1C) |
377,694 |
371,498 |
$1.38M |
| 82607 |
|
191,632 |
188,538 |
$1.33M |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
445,921 |
432,020 |
$1.24M |
| 84443 |
Thyroid stimulating hormone (TSH) |
241,135 |
236,486 |
$1.23M |
| 86803 |
|
140,530 |
138,075 |
$987K |
| 87801 |
Infectious agent detection by nucleic acid; amplified probe, multiple organisms |
31,722 |
30,404 |
$974K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
53,787 |
48,810 |
$970K |
| 82746 |
|
131,131 |
129,201 |
$896K |
| 84439 |
|
201,047 |
197,577 |
$842K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
17,959 |
16,942 |
$821K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
214,366 |
201,012 |
$819K |
| 87481 |
|
38,572 |
37,438 |
$809K |
| 86003 |
|
17,021 |
15,138 |
$755K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
25,141 |
24,404 |
$738K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
7,953 |
7,827 |
$736K |
| 81220 |
CFTR (cystic fibrosis transmembrane conductance regulator) gene analysis; common variants |
3,581 |
3,568 |
$696K |
| 82728 |
|
99,626 |
97,002 |
$598K |
| 83013 |
|
17,095 |
16,760 |
$580K |
| 81001 |
|
344,698 |
334,483 |
$575K |
| 84403 |
|
40,041 |
39,290 |
$546K |
| 87340 |
|
93,824 |
93,017 |
$543K |
| 86706 |
|
95,631 |
94,190 |
$534K |
| 84153 |
|
66,224 |
63,213 |
$527K |
| 84481 |
|
73,314 |
72,267 |
$521K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
5,443 |
5,127 |
$512K |
| 86696 |
|
57,624 |
55,888 |
$503K |
| 87070 |
|
121,854 |
113,032 |
$501K |
| 87077 |
|
96,533 |
88,328 |
$484K |
| 80074 |
|
33,040 |
31,859 |
$456K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
8,770 |
8,671 |
$405K |
| 86762 |
|
46,914 |
46,233 |
$362K |
| 87186 |
|
80,633 |
76,331 |
$360K |
| 82670 |
|
23,918 |
23,564 |
$355K |
| 83001 |
|
34,565 |
34,198 |
$354K |
| 83655 |
|
51,315 |
51,103 |
$349K |
| 87511 |
|
23,813 |
23,562 |
$339K |
| 81514 |
|
4,846 |
4,705 |
$339K |
| 86235 |
|
17,058 |
16,669 |
$321K |
| 83970 |
|
15,778 |
15,492 |
$317K |
| 86592 |
|
150,204 |
145,976 |
$316K |
| 83002 |
|
31,262 |
30,897 |
$315K |
| 81513 |
|
12,368 |
11,546 |
$313K |
| 86765 |
|
44,207 |
43,641 |
$310K |
| 88141 |
|
27,015 |
26,809 |
$306K |
| 84702 |
|
42,079 |
38,525 |
$301K |
| 83550 |
|
93,807 |
91,633 |
$295K |
| 84146 |
|
27,663 |
27,266 |
$290K |
| 86708 |
|
44,510 |
43,841 |
$283K |
| 86695 |
|
53,636 |
52,288 |
$282K |
| 86787 |
|
42,011 |
41,442 |
$282K |
| 83540 |
|
108,059 |
105,434 |
$280K |
| 86704 |
|
46,153 |
45,418 |
$271K |
| 87480 |
|
25,245 |
24,708 |
$261K |
| 87510 |
|
24,122 |
23,604 |
$252K |
| 86735 |
|
39,274 |
38,737 |
$239K |
| 87536 |
|
4,050 |
3,930 |
$238K |
| 86780 |
|
36,438 |
35,769 |
$229K |
| 87522 |
Neg quan hep c or qual rna |
8,910 |
8,661 |
$222K |
| 86694 |
|
34,326 |
33,280 |
$209K |
| 86038 |
|
42,263 |
41,306 |
$201K |
| 87634 |
|
9,639 |
9,183 |
$200K |
| 86376 |
|
26,492 |
26,145 |
$199K |
| 87081 |
|
55,535 |
54,697 |
$189K |
| 80081 |
|
5,805 |
5,739 |
$189K |
| 82570 |
|
74,098 |
72,125 |
$180K |
| 82043 |
|
69,343 |
68,433 |
$180K |
| 87660 |
|
17,299 |
16,928 |
$178K |
| G0480 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed |
7,544 |
7,047 |
$178K |
| 84550 |
|
74,652 |
73,130 |
$173K |
| 84144 |
|
15,449 |
14,461 |
$170K |
| 85027 |
|
56,524 |
55,683 |
$167K |
| 83021 |
|
17,103 |
17,000 |
$166K |
| 88112 |
|
5,880 |
5,702 |
$166K |
| 84270 |
|
22,010 |
21,165 |
$163K |
| 87529 |
|
5,692 |
5,571 |
$161K |
| 82627 |
|
13,036 |
12,930 |
$152K |
| 86800 |
|
19,596 |
19,255 |
$152K |
| 84480 |
|
28,556 |
28,128 |
$150K |
| 86618 |
|
14,969 |
14,335 |
$150K |
| 81511 |
|
2,672 |
2,669 |
$149K |
| 84154 |
|
15,344 |
15,139 |
$142K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
39,605 |
38,290 |
$137K |
| 82784 |
|
19,758 |
17,490 |
$135K |
| 83735 |
|
47,279 |
45,521 |
$135K |
| 81420 |
Fetal chromosomal aneuploidy genomic sequence analysis panel |
874 |
873 |
$126K |
| 86140 |
|
54,650 |
53,044 |
$125K |
| 82652 |
|
13,580 |
13,473 |
$122K |
| 87517 |
|
9,263 |
9,199 |
$122K |
| 86364 |
|
8,601 |
8,155 |
$116K |
| 82248 |
|
47,351 |
46,167 |
$116K |
| 88142 |
|
10,132 |
10,095 |
$116K |
| 82785 |
|
14,173 |
13,852 |
$115K |
| 86147 |
|
5,365 |
4,752 |
$111K |
| 86617 |
|
9,065 |
7,708 |
$110K |
| 84436 |
|
39,369 |
38,682 |
$110K |
| 87563 |
|
8,099 |
7,928 |
$108K |
| 88342 |
|
2,697 |
2,208 |
$107K |
| 83521 |
|
2,988 |
2,901 |
$100K |
| 86709 |
|
17,796 |
17,365 |
$99K |
| 86160 |
|
12,313 |
9,735 |
$99K |
| 83525 |
|
16,472 |
16,187 |
$97K |
| 86665 |
|
5,411 |
4,818 |
$96K |
| 86360 |
|
3,136 |
3,080 |
$94K |
| 87467 |
|
14,028 |
13,580 |
$89K |
| 87350 |
|
15,702 |
15,404 |
$89K |
| 85652 |
|
73,101 |
71,299 |
$88K |
| 86707 |
|
15,528 |
15,222 |
$88K |
| 84402 |
|
6,315 |
6,269 |
$87K |
| 83498 |
|
5,771 |
5,734 |
$86K |
| 82105 |
|
14,113 |
13,996 |
$83K |
| 87147 |
|
37,905 |
36,556 |
$77K |
| 86430 |
|
25,258 |
25,058 |
$76K |
| 36415 |
Collection of venous blood by venipuncture |
281,171 |
260,292 |
$72K |
| 86225 |
|
14,531 |
14,174 |
$72K |
| 83516 |
|
10,668 |
10,045 |
$71K |
| 80076 |
|
18,434 |
18,070 |
$71K |
| 86255 |
|
12,032 |
11,753 |
$69K |
| 82626 |
|
4,937 |
4,914 |
$67K |
| 86200 |
|
16,567 |
16,380 |
$65K |
| 82533 |
|
7,745 |
7,552 |
$64K |
| 86334 |
|
6,516 |
6,395 |
$63K |
| 82550 |
|
22,422 |
21,657 |
$63K |
| 83520 |
|
11,046 |
10,868 |
$61K |
| 83690 |
|
17,739 |
17,276 |
$57K |
| 86008 |
|
2,159 |
2,064 |
$57K |
| 83090 |
|
6,018 |
5,983 |
$57K |
| 86705 |
|
10,338 |
10,058 |
$56K |
| 83880 |
|
4,170 |
3,964 |
$56K |
| 84100 |
|
23,639 |
22,562 |
$55K |
| 86258 |
|
3,893 |
3,300 |
$54K |
| 86141 |
|
9,184 |
8,958 |
$54K |
| 86747 |
|
4,662 |
3,942 |
$53K |
| 88361 |
|
799 |
790 |
$52K |
| 86015 |
|
3,135 |
2,552 |
$51K |
| 85610 |
|
28,667 |
26,077 |
$51K |
| 81329 |
|
1,676 |
1,667 |
$50K |
| 82274 |
|
9,374 |
9,292 |
$50K |
| 87653 |
|
3,232 |
3,198 |
$50K |
| 82977 |
|
17,632 |
16,680 |
$49K |
| 84445 |
|
3,139 |
3,090 |
$48K |
| 84425 |
|
5,093 |
5,013 |
$48K |
| 84165 |
|
10,623 |
10,444 |
$48K |
| 86317 |
|
4,850 |
4,825 |
$48K |
| 84479 |
|
20,225 |
20,043 |
$47K |
| 82378 |
|
5,545 |
5,171 |
$47K |
| 87631 |
|
1,117 |
1,080 |
$46K |
| 82465 |
|
21,935 |
21,359 |
$46K |
| 82150 |
|
14,839 |
14,430 |
$45K |
| 84681 |
|
4,150 |
4,115 |
$43K |
| 85730 |
|
19,453 |
18,728 |
$42K |
| 87255 |
|
2,997 |
2,957 |
$41K |
| 86757 |
|
2,418 |
2,319 |
$41K |
| 86146 |
|
2,014 |
1,725 |
$38K |
| 86357 |
|
2,200 |
2,183 |
$37K |
| 82951 |
|
6,787 |
6,576 |
$37K |
| 82157 |
|
2,411 |
2,402 |
$37K |
| 87338 |
|
6,298 |
6,260 |
$36K |
| 86850 |
|
9,947 |
9,738 |
$36K |
| 86359 |
|
2,203 |
2,148 |
$36K |
| 82950 |
|
14,392 |
14,279 |
$34K |
| 82024 |
|
1,795 |
1,753 |
$33K |
| 87045 |
|
4,839 |
4,373 |
$33K |
| 83615 |
|
12,409 |
11,804 |
$33K |
| 81243 |
|
2,771 |
2,757 |
$33K |
| 82677 |
|
2,511 |
2,498 |
$32K |
| 84163 |
|
3,978 |
3,976 |
$32K |
| 87902 |
|
182 |
180 |
$31K |
| 87106 |
|
5,392 |
5,203 |
$30K |
| 86664 |
|
3,581 |
3,452 |
$29K |
| 86666 |
|
3,175 |
2,842 |
$29K |
| 87177 |
|
5,540 |
5,217 |
$29K |
| 81596 |
|
1,289 |
1,281 |
$28K |
| 84460 |
|
10,592 |
10,327 |
$28K |
| 82671 |
|
2,974 |
2,958 |
$27K |
| 86812 |
|
2,998 |
2,893 |
$27K |
| 86901 |
|
15,507 |
15,255 |
$27K |
| 81401 |
|
665 |
658 |
$27K |
| 81507 |
|
230 |
227 |
$27K |
| 84156 |
|
15,521 |
14,762 |
$26K |
| 83921 |
|
2,520 |
2,498 |
$26K |
| 86900 |
|
15,721 |
15,468 |
$25K |
| 88173 |
|
536 |
451 |
$25K |
| 80069 |
|
3,848 |
3,752 |
$25K |
| 86663 |
|
3,437 |
3,311 |
$24K |
| 83721 |
|
11,565 |
11,287 |
$24K |
| 87329 |
|
3,716 |
3,484 |
$23K |
| 86777 |
|
2,902 |
2,863 |
$23K |
| 86304 |
|
2,844 |
2,762 |
$23K |
| 87102 |
|
4,553 |
4,527 |
$22K |
| 84207 |
|
1,638 |
1,602 |
$22K |
| 86231 |
|
3,212 |
3,133 |
$22K |
| 84305 |
|
2,041 |
2,012 |
$22K |
| 80349 |
|
6,718 |
6,280 |
$21K |
| 86039 |
|
4,783 |
4,655 |
$21K |
| 84466 |
|
3,836 |
3,705 |
$21K |
| 85045 |
|
11,217 |
11,040 |
$20K |
| 86021 |
|
3,909 |
3,810 |
$20K |
| 81376 |
|
521 |
520 |
$20K |
| 86300 |
|
2,448 |
2,244 |
$20K |
| 83010 |
|
3,428 |
3,388 |
$20K |
| 82672 |
|
1,753 |
1,727 |
$20K |
| 87799 |
|
457 |
444 |
$20K |
| 86738 |
|
1,699 |
1,690 |
$20K |
| 80348 |
|
3,283 |
2,896 |
$19K |
| 80055 |
|
813 |
809 |
$19K |
| 84590 |
|
2,948 |
2,931 |
$19K |
| 87581 |
|
1,174 |
1,163 |
$19K |
| 87486 |
|
1,163 |
1,152 |
$19K |
| 84703 |
|
6,501 |
6,333 |
$19K |
| 87046 |
|
4,233 |
4,121 |
$19K |
| 86355 |
|
1,251 |
1,236 |
$19K |
| 82172 |
|
1,786 |
1,769 |
$18K |
| 82985 |
|
2,609 |
2,588 |
$17K |
| 87209 |
|
2,757 |
2,502 |
$17K |
| 86671 |
|
1,785 |
1,744 |
$17K |
| 86778 |
|
2,250 |
2,223 |
$17K |
| 84432 |
|
3,184 |
3,104 |
$17K |
| 88120 |
|
74 |
74 |
$17K |
| 86431 |
|
7,082 |
6,926 |
$16K |
| 84075 |
|
6,613 |
6,417 |
$16K |
| 80365 |
|
5,939 |
5,277 |
$16K |
| 82088 |
|
957 |
857 |
$16K |
| 86336 |
|
2,184 |
2,177 |
$16K |
| 85379 |
|
3,015 |
2,899 |
$15K |
| 86256 |
|
1,944 |
1,932 |
$15K |
| 82668 |
|
2,144 |
2,094 |
$15K |
| 86710 |
|
1,029 |
956 |
$15K |
| 84478 |
|
7,375 |
7,200 |
$15K |
| 82397 |
|
3,235 |
3,200 |
$14K |
| 84630 |
|
2,665 |
2,651 |
$14K |
| 80164 |
|
2,532 |
2,363 |
$14K |
| 83883 |
|
1,792 |
1,724 |
$14K |
| 86644 |
|
1,791 |
1,737 |
$14K |
| 82653 |
|
641 |
631 |
$13K |
| 82164 |
|
2,755 |
2,715 |
$13K |
| 81002 |
|
9,004 |
8,899 |
$13K |
| 87075 |
|
2,955 |
2,448 |
$13K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
223 |
217 |
$13K |
| 86036 |
|
890 |
885 |
$12K |
| 86645 |
|
1,582 |
1,531 |
$12K |
| 82330 |
|
2,190 |
2,118 |
$12K |
| 84181 |
|
909 |
857 |
$12K |
| 82390 |
|
2,415 |
2,401 |
$12K |
| 82947 |
|
6,104 |
6,001 |
$12K |
| 84450 |
|
9,806 |
9,543 |
$12K |
| 86356 |
|
1,492 |
1,486 |
$12K |
| 82525 |
|
1,713 |
1,695 |
$12K |
| 87625 |
|
1,250 |
1,229 |
$12K |
| 83993 |
|
1,565 |
1,551 |
$12K |
| 82103 |
|
1,776 |
1,721 |
$12K |
| 87324 |
|
2,069 |
2,030 |
$12K |
| 88184 |
|
733 |
726 |
$12K |
| 87469 |
|
752 |
635 |
$11K |
| 87449 |
|
2,533 |
2,480 |
$11K |
| 87341 |
|
2,015 |
1,984 |
$11K |
| 88189 |
|
530 |
524 |
$10K |
| 85613 |
|
2,324 |
2,175 |
$10K |
| 84446 |
|
1,339 |
1,330 |
$10K |
| 83789 |
|
1,141 |
1,097 |
$9K |
| 86611 |
|
701 |
699 |
$9K |
| 87468 |
|
704 |
602 |
$9K |
| 87507 |
|
138 |
137 |
$9K |
| 86677 |
|
679 |
655 |
$9K |
| 82565 |
|
4,377 |
4,179 |
$9K |
| 87272 |
|
1,350 |
1,234 |
$9K |
| 82166 |
|
657 |
645 |
$9K |
| 86593 |
|
3,910 |
3,761 |
$9K |
| 87328 |
|
1,517 |
1,390 |
$9K |
| 87109 |
|
1,261 |
1,236 |
$9K |
| 84166 |
|
1,079 |
1,058 |
$8K |
| 86631 |
|
796 |
794 |
$8K |
| 84080 |
|
1,333 |
1,310 |
$8K |
| 81003 |
|
8,486 |
7,929 |
$8K |
| 87185 |
|
3,478 |
3,256 |
$8K |
| 87484 |
|
622 |
552 |
$8K |
| 88262 |
|
141 |
139 |
$8K |
| 84155 |
|
8,903 |
8,684 |
$8K |
| 82787 |
|
663 |
650 |
$8K |
| 84255 |
|
773 |
768 |
$8K |
| 86301 |
|
1,276 |
1,181 |
$8K |
| 82955 |
|
1,505 |
1,481 |
$7K |
| 82232 |
|
1,242 |
1,211 |
$7K |
| 87101 |
|
1,743 |
1,669 |
$7K |
| 83695 |
|
1,937 |
1,931 |
$7K |
| 82642 |
|
755 |
642 |
$7K |
| 80346 |
|
2,555 |
2,416 |
$7K |
| 82310 |
|
3,326 |
3,158 |
$7K |
| 81256 |
|
455 |
455 |
$7K |
| 84520 |
|
4,040 |
3,866 |
$7K |
| 86341 |
|
798 |
747 |
$6K |
| 87912 |
|
67 |
67 |
$6K |
| 82085 |
|
1,920 |
1,877 |
$6K |
| 84484 |
|
1,408 |
1,337 |
$6K |
| 81241 |
|
330 |
328 |
$6K |
| 80324 |
|
2,027 |
1,894 |
$6K |
| 84482 |
|
1,289 |
1,274 |
$6K |
| 80178 |
|
1,791 |
1,606 |
$6K |
| 80177 |
|
1,144 |
1,122 |
$6K |
| 86753 |
|
911 |
760 |
$6K |
| 86335 |
|
490 |
484 |
$6K |
| 82308 |
|
468 |
466 |
$6K |
| 86632 |
|
794 |
791 |
$6K |
| 87478 |
|
415 |
413 |
$6K |
| 86063 |
|
2,159 |
2,129 |
$6K |
| 84378 |
|
915 |
908 |
$6K |
| 87471 |
|
470 |
464 |
$6K |
| 86308 |
|
2,072 |
2,039 |
$6K |
| 87512 |
|
355 |
354 |
$6K |
| 85660 |
|
2,458 |
2,420 |
$6K |
| 80159 |
|
771 |
571 |
$6K |
| 83718 |
|
3,037 |
3,007 |
$5K |
| 87623 |
|
1,151 |
1,151 |
$5K |
| 88185 |
|
132 |
131 |
$5K |
| 80361 |
|
1,823 |
1,714 |
$5K |
| 83835 |
|
627 |
594 |
$5K |
| 80359 |
|
2,310 |
1,840 |
$5K |
| 82180 |
|
976 |
967 |
$5K |
| 81291 |
|
567 |
555 |
$5K |
| 88280 |
|
434 |
429 |
$5K |
| 82679 |
|
259 |
258 |
$4K |
| 83519 |
|
803 |
779 |
$4K |
| 82552 |
|
719 |
699 |
$4K |
| 85240 |
|
639 |
626 |
$4K |
| 84244 |
|
782 |
749 |
$4K |
| 86702 |
|
961 |
915 |
$4K |
| 82247 |
|
6,209 |
5,983 |
$4K |
| 86692 |
|
400 |
392 |
$4K |
| 82610 |
|
705 |
668 |
$4K |
| 86885 |
|
1,799 |
1,760 |
$4K |
| 87040 |
|
462 |
372 |
$4K |
| 83630 |
|
536 |
526 |
$4K |
| 85384 |
|
808 |
788 |
$4K |
| 82270 |
|
1,828 |
1,804 |
$3K |
| 85007 |
|
2,576 |
2,241 |
$3K |
| 82107 |
|
140 |
139 |
$3K |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
823 |
816 |
$3K |
| 87205 |
|
1,704 |
1,567 |
$3K |
| 84134 |
|
511 |
507 |
$3K |
| 81015 |
|
2,244 |
2,122 |
$3K |
| 85246 |
|
333 |
329 |
$3K |
| 82040 |
|
5,553 |
5,392 |
$3K |
| 86701 |
|
982 |
936 |
$3K |
| 84442 |
|
446 |
443 |
$3K |
| 87641 |
|
168 |
165 |
$3K |
| 86340 |
|
406 |
404 |
$3K |
| 81240 |
|
156 |
154 |
$3K |
| 80362 |
|
830 |
636 |
$3K |
| 82952 |
|
948 |
936 |
$2K |
| 86148 |
|
229 |
228 |
$2K |
| 86622 |
|
527 |
526 |
$2K |
| 83704 |
|
365 |
362 |
$2K |
| 86886 |
|
816 |
809 |
$2K |
| 80320 |
|
383 |
369 |
$2K |
| 80353 |
|
1,085 |
987 |
$2K |
| 83014 |
|
775 |
769 |
$2K |
| 86337 |
|
294 |
292 |
$2K |
| 87593 |
|
49 |
49 |
$2K |
| 84132 |
|
1,066 |
1,008 |
$2K |
| 86331 |
|
293 |
286 |
$2K |
| 82239 |
|
292 |
257 |
$2K |
| 88304 |
|
83 |
82 |
$2K |
| 82747 |
|
191 |
190 |
$2K |
| 84300 |
|
872 |
854 |
$2K |
| 80051 |
|
618 |
527 |
$2K |
| G0145 |
Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision |
417 |
416 |
$2K |
| 83003 |
|
197 |
195 |
$2K |
| 82530 |
|
214 |
201 |
$2K |
| 85245 |
|
211 |
211 |
$2K |
| 85306 |
|
192 |
188 |
$1K |
| 80175 |
|
225 |
212 |
$1K |
| 81050 |
|
1,229 |
1,208 |
$1K |
| 88341 |
|
54 |
40 |
$1K |
| 84597 |
|
183 |
181 |
$1K |
| 80197 |
|
243 |
175 |
$1K |
| 83020 |
|
189 |
185 |
$1K |
| 85014 |
|
1,270 |
1,245 |
$1K |
| 86361 |
|
74 |
74 |
$1K |
| 86215 |
|
181 |
181 |
$1K |
| 82542 |
|
143 |
141 |
$1K |
| 85018 |
|
1,222 |
1,195 |
$1K |
| 87476 |
|
50 |
49 |
$1K |
| 80358 |
|
585 |
526 |
$1K |
| 87273 |
|
137 |
137 |
$1K |
| 86162 |
|
94 |
94 |
$1K |
| 82608 |
|
119 |
119 |
$1K |
| 82710 |
|
86 |
86 |
$999.08 |
| 86658 |
|
94 |
93 |
$989.45 |
| 82495 |
|
70 |
70 |
$980.94 |
| 83698 |
|
53 |
53 |
$979.82 |
| 82272 |
|
570 |
558 |
$861.78 |
| 84238 |
|
165 |
163 |
$848.39 |
| 85303 |
|
118 |
117 |
$844.82 |
| 85300 |
|
148 |
148 |
$819.33 |
| 87493 |
|
64 |
64 |
$803.51 |
| 81257 |
|
330 |
329 |
$776.77 |
| 82140 |
|
106 |
100 |
$770.78 |
| 87274 |
|
90 |
90 |
$711.81 |
| 81361 |
|
25 |
25 |
$699.28 |
| 87015 |
|
280 |
243 |
$654.09 |
| 82595 |
|
235 |
231 |
$618.99 |
| 85247 |
|
86 |
86 |
$568.94 |
| 82731 |
|
13 |
12 |
$560.68 |
| 88235 |
|
12 |
12 |
$558.55 |
| 82365 |
|
82 |
79 |
$533.56 |
| 85049 |
|
730 |
685 |
$487.50 |
| 82384 |
|
55 |
55 |
$485.86 |
| 0107U |
|
215 |
210 |
$475.24 |
| 86870 |
|
41 |
40 |
$422.92 |
| 83527 |
|
60 |
59 |
$422.12 |
| 82374 |
|
358 |
348 |
$397.45 |
| 84295 |
|
513 |
491 |
$386.08 |
| 84704 |
|
60 |
59 |
$382.31 |
| 88108 |
|
85 |
85 |
$371.44 |
| 80414 |
|
12 |
12 |
$369.23 |
| 86880 |
|
187 |
181 |
$346.53 |
| 87280 |
|
54 |
54 |
$339.60 |
| 87535 |
|
43 |
38 |
$339.50 |
| 84588 |
|
13 |
13 |
$334.65 |
| 84586 |
|
13 |
13 |
$296.91 |
| 83825 |
|
24 |
24 |
$295.44 |
| 87168 |
|
201 |
189 |
$286.95 |
| 81270 |
|
25 |
25 |
$274.98 |
| 89060 |
|
83 |
73 |
$273.62 |
| 87400 |
|
28 |
28 |
$272.67 |
| 87252 |
|
13 |
13 |
$233.28 |
| 85305 |
|
26 |
26 |
$229.74 |
| P9603 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated miles actually travelled |
227 |
175 |
$229.27 |
| 87497 |
|
21 |
12 |
$227.68 |
| 80306 |
|
31 |
29 |
$220.22 |
| 82435 |
|
424 |
403 |
$215.03 |
| 80325 |
|
265 |
226 |
$206.28 |
| 87116 |
|
36 |
27 |
$200.88 |
| 80373 |
|
13 |
13 |
$171.12 |
| G0476 |
Infectious agent detection by nucleic acid (dna or rna); human papillomavirus (hpv), high-risk types (e.g., 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68) for cervical cancer screening, must be performed in addition to pap test |
66 |
66 |
$143.31 |
| 85302 |
|
12 |
12 |
$141.63 |
| 80354 |
|
317 |
271 |
$140.10 |
| G0472 |
Hepatitis c antibody screening, for individual at high risk and other covered indication(s) |
89 |
89 |
$139.05 |
| 82575 |
|
28 |
28 |
$129.93 |
| 82104 |
|
13 |
12 |
$123.76 |
| 85046 |
|
44 |
43 |
$117.78 |
| 80183 |
|
12 |
12 |
$103.98 |
| 85307 |
|
12 |
12 |
$98.18 |
| 82681 |
|
13 |
13 |
$97.79 |
| 83935 |
|
40 |
38 |
$74.98 |
| 87210 |
|
26 |
26 |
$64.64 |
| 86682 |
|
12 |
12 |
$62.49 |
| 84133 |
|
31 |
30 |
$54.68 |
| 83930 |
|
15 |
15 |
$54.21 |
| 82436 |
|
27 |
26 |
$49.80 |
| 85597 |
|
14 |
14 |
$46.75 |
| 85041 |
|
29 |
28 |
$45.36 |
| 85598 |
|
13 |
13 |
$44.95 |
| 87206 |
|
17 |
13 |
$41.03 |
| 87140 |
|
14 |
14 |
$40.10 |
| 82340 |
|
12 |
12 |
$39.82 |
| 89320 |
|
291 |
288 |
$38.78 |
| 89051 |
|
13 |
12 |
$38.39 |
| 85670 |
|
12 |
12 |
$25.73 |
| 89050 |
|
15 |
14 |
$24.32 |
| 87181 |
|
13 |
12 |
$20.14 |
| 80047 |
|
27 |
27 |
$0.00 |
| 99080 |
|
362 |
155 |
$0.00 |
| P9604 |
Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge |
18 |
14 |
$0.00 |