| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 80050 |
General health panel |
630 |
626 |
$26K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
1,534 |
1,461 |
$17K |
| 84403 |
|
927 |
911 |
$13K |
| 82670 |
|
826 |
812 |
$12K |
| 84270 |
|
909 |
888 |
$11K |
| 83001 |
|
890 |
881 |
$9K |
| 83002 |
|
887 |
879 |
$9K |
| 80061 |
Lipid panel |
3,128 |
2,983 |
$9K |
| 82533 |
|
927 |
910 |
$8K |
| 82728 |
|
1,106 |
1,079 |
$8K |
| 82607 |
|
1,276 |
1,230 |
$8K |
| 82746 |
|
1,253 |
1,217 |
$8K |
| 83880 |
|
829 |
750 |
$8K |
| 84481 |
|
921 |
904 |
$8K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,846 |
3,662 |
$7K |
| 84466 |
|
1,031 |
1,000 |
$7K |
| 86376 |
|
754 |
748 |
$7K |
| 84134 |
|
852 |
830 |
$6K |
| 86141 |
|
976 |
954 |
$6K |
| 86800 |
|
653 |
645 |
$6K |
| 83525 |
|
892 |
879 |
$6K |
| 82627 |
|
630 |
620 |
$6K |
| 84146 |
|
671 |
660 |
$5K |
| 84144 |
|
502 |
499 |
$5K |
| 83540 |
|
1,083 |
1,051 |
$4K |
| 84439 |
|
1,114 |
1,069 |
$3K |
| 84402 |
|
146 |
145 |
$3K |
| 84550 |
|
1,217 |
1,164 |
$2K |
| G0482 |
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; 15-21 drug class(es), including metabolite(s) if performed |
294 |
286 |
$2K |
| 83690 |
|
786 |
773 |
$2K |
| 83498 |
|
142 |
139 |
$2K |
| 82150 |
|
794 |
776 |
$2K |
| 84153 |
|
235 |
234 |
$2K |
| 82172 |
|
411 |
401 |
$2K |
| 84432 |
|
289 |
283 |
$2K |
| 80053 |
Comprehensive metabolic panel |
6,712 |
5,726 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
553 |
531 |
$1K |
| 84436 |
|
922 |
898 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
7,807 |
6,465 |
$1K |
| 83550 |
|
398 |
391 |
$1K |
| 84479 |
|
521 |
511 |
$1K |
| 82610 |
|
379 |
368 |
$1K |
| 83090 |
|
451 |
443 |
$937.86 |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,943 |
2,755 |
$876.65 |
| 82248 |
|
646 |
633 |
$823.10 |
| 84480 |
|
464 |
446 |
$784.96 |
| 83970 |
|
139 |
132 |
$747.48 |
| 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 |
255 |
246 |
$630.40 |
| 83735 |
|
781 |
730 |
$523.35 |
| 84702 |
|
165 |
161 |
$512.69 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
13 |
13 |
$463.32 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
13 |
13 |
$463.32 |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
13 |
13 |
$463.32 |
| 86431 |
|
417 |
405 |
$449.03 |
| 82105 |
|
328 |
316 |
$445.00 |
| 83615 |
|
505 |
494 |
$438.26 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$427.68 |
| 85652 |
|
286 |
276 |
$418.50 |
| 85045 |
|
281 |
278 |
$395.56 |
| 82784 |
|
248 |
240 |
$389.50 |
| 84100 |
|
564 |
548 |
$337.75 |
| 82977 |
|
454 |
442 |
$332.98 |
| 80164 |
|
604 |
549 |
$199.79 |
| 80185 |
|
390 |
312 |
$196.98 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,772 |
1,567 |
$179.49 |
| 82550 |
|
157 |
148 |
$114.88 |
| 87186 |
|
919 |
832 |
$45.91 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,341 |
1,009 |
$38.96 |
| 87088 |
|
881 |
804 |
$34.58 |
| 81001 |
|
1,866 |
1,667 |
$28.12 |
| 80156 |
|
155 |
134 |
$16.78 |
| 84446 |
|
32 |
25 |
$14.71 |
| 80184 |
|
13 |
12 |
$13.20 |
| 82947 |
|
126 |
121 |
$12.77 |
| 81000 |
|
336 |
278 |
$10.95 |
| 80076 |
|
105 |
101 |
$9.42 |
| 85610 |
|
1,706 |
675 |
$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 |
1,022 |
708 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
94 |
88 |
$0.00 |
| 82570 |
|
164 |
139 |
$0.00 |
| 83695 |
|
18 |
12 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$0.00 |
| 80162 |
|
97 |
84 |
$0.00 |
| 82565 |
|
18 |
18 |
$0.00 |
| 84520 |
|
16 |
16 |
$0.00 |
| 82247 |
|
12 |
12 |
$0.00 |
| 87070 |
|
69 |
62 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
102 |
90 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
10,435 |
6,755 |
$0.00 |
| 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 |
3,475 |
2,277 |
$0.00 |
| 82040 |
|
13 |
12 |
$0.00 |
| 86430 |
|
25 |
25 |
$0.00 |
| 80069 |
|
35 |
25 |
$0.00 |
| 84132 |
|
13 |
12 |
$0.00 |
| 80177 |
|
103 |
93 |
$0.00 |
| 85651 |
|
45 |
25 |
$0.00 |
| 82043 |
|
142 |
124 |
$0.00 |
| 86140 |
|
395 |
321 |
$0.00 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
30 |
30 |
$0.00 |