| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87480 |
|
160 |
158 |
$19K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
81 |
80 |
$13K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
79 |
78 |
$8K |
| 87510 |
|
110 |
108 |
$7K |
| 87660 |
|
110 |
108 |
$6K |
| 86803 |
|
57 |
56 |
$5K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
57 |
56 |
$4K |
| 87340 |
|
57 |
56 |
$3K |
| 86780 |
|
57 |
56 |
$2K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
14 |
14 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
30 |
30 |
$822.36 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
13 |
13 |
$339.77 |
| 81001 |
|
13 |
13 |
$160.94 |