| Code | Description | Claims | Beneficiaries | Total Paid |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
3,572 |
3,385 |
$121K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
3,572 |
3,387 |
$120K |
| 87481 |
|
2,832 |
1,383 |
$94K |
| 80050 |
General health panel |
2,575 |
2,495 |
$87K |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
2,387 |
2,307 |
$85K |
| 88175 |
Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer |
2,336 |
2,227 |
$73K |
| 80061 |
Lipid panel |
4,738 |
4,605 |
$65K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,063 |
997 |
$65K |
| 80053 |
Comprehensive metabolic panel |
6,181 |
5,856 |
$56K |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,155 |
3,065 |
$55K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
1,470 |
1,423 |
$53K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
6,543 |
6,101 |
$51K |
| 87511 |
|
1,426 |
1,384 |
$49K |
| 36415 |
Collection of venous blood by venipuncture |
18,201 |
16,358 |
$41K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
1,897 |
1,796 |
$41K |
| 87902 |
|
126 |
123 |
$36K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
3,274 |
3,194 |
$33K |
| 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 |
555 |
507 |
$31K |
| 86003 |
|
414 |
279 |
$27K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
3,195 |
2,946 |
$25K |
| 86780 |
|
1,901 |
1,754 |
$23K |
| 87340 |
|
2,098 |
1,957 |
$20K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
696 |
667 |
$20K |
| 87522 |
Neg quan hep c or qual rna |
420 |
408 |
$20K |
| 82607 |
|
1,165 |
1,131 |
$18K |
| 86480 |
|
308 |
293 |
$18K |
| 86803 |
|
1,237 |
1,170 |
$16K |
| 83970 |
|
363 |
354 |
$16K |
| 86762 |
|
1,217 |
1,124 |
$15K |
| 84702 |
|
905 |
736 |
$14K |
| 84439 |
|
1,516 |
1,463 |
$13K |
| 85027 |
|
2,008 |
1,930 |
$13K |
| 83013 |
|
176 |
173 |
$12K |
| 86235 |
|
270 |
152 |
$12K |
| 82728 |
|
880 |
843 |
$12K |
| 83880 |
|
314 |
298 |
$11K |
| 87070 |
|
1,380 |
1,278 |
$11K |
| 87081 |
|
1,581 |
1,504 |
$11K |
| 84403 |
|
402 |
382 |
$10K |
| 87186 |
|
1,159 |
1,084 |
$10K |
| 83516 |
|
783 |
436 |
$9K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,379 |
1,251 |
$9K |
| 82570 |
|
1,620 |
1,567 |
$9K |
| 86706 |
|
771 |
748 |
$9K |
| 86696 |
|
412 |
386 |
$7K |
| 82043 |
|
1,157 |
1,137 |
$7K |
| 88141 |
|
382 |
376 |
$7K |
| 86140 |
|
1,302 |
1,237 |
$7K |
| 84153 |
|
364 |
352 |
$7K |
| 83550 |
|
765 |
732 |
$7K |
| 82670 |
|
236 |
222 |
$7K |
| 84480 |
|
435 |
427 |
$7K |
| 82105 |
|
405 |
381 |
$6K |
| 82746 |
|
404 |
386 |
$6K |
| 87493 |
|
173 |
159 |
$6K |
| 86704 |
|
524 |
493 |
$6K |
| 83001 |
|
335 |
322 |
$6K |
| 82677 |
|
237 |
226 |
$6K |
| 87205 |
|
1,262 |
1,193 |
$6K |
| 86708 |
|
420 |
413 |
$6K |
| 84402 |
|
230 |
221 |
$6K |
| 84146 |
|
271 |
260 |
$5K |
| 86038 |
|
475 |
445 |
$5K |
| 86160 |
|
419 |
200 |
$5K |
| 83540 |
|
780 |
746 |
$5K |
| 86695 |
|
379 |
357 |
$5K |
| 81001 |
|
1,356 |
1,295 |
$4K |
| 87517 |
|
96 |
93 |
$4K |
| 82950 |
|
870 |
843 |
$4K |
| 86850 |
|
1,250 |
1,152 |
$4K |
| 85652 |
|
1,358 |
1,300 |
$4K |
| 86200 |
|
286 |
270 |
$4K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
72 |
49 |
$4K |
| 80076 |
|
564 |
536 |
$4K |
| 86694 |
|
265 |
261 |
$4K |
| 83655 |
|
328 |
323 |
$3K |
| 83002 |
|
203 |
194 |
$3K |
| 86900 |
|
1,184 |
1,097 |
$3K |
| 84550 |
|
735 |
691 |
$3K |
| 86901 |
|
1,164 |
1,080 |
$3K |
| 82951 |
|
236 |
231 |
$3K |
| 86336 |
|
239 |
228 |
$3K |
| 86800 |
|
186 |
173 |
$3K |
| 86225 |
|
224 |
175 |
$3K |
| 87147 |
|
581 |
544 |
$3K |
| 83735 |
|
392 |
329 |
$3K |
| 85610 |
|
664 |
577 |
$3K |
| 87536 |
|
30 |
27 |
$3K |
| 87529 |
|
70 |
58 |
$3K |
| 82784 |
|
245 |
195 |
$3K |
| 86431 |
|
437 |
397 |
$2K |
| 80074 |
|
58 |
55 |
$2K |
| 86376 |
|
172 |
165 |
$2K |
| 83690 |
|
322 |
309 |
$2K |
| 87899 |
|
206 |
190 |
$2K |
| 87427 |
|
202 |
186 |
$2K |
| 84156 |
|
568 |
528 |
$2K |
| 86812 |
|
101 |
98 |
$2K |
| 87338 |
|
177 |
170 |
$2K |
| 84144 |
|
104 |
91 |
$2K |
| 82533 |
|
125 |
117 |
$2K |
| 82627 |
|
94 |
88 |
$2K |
| 87077 |
|
252 |
237 |
$2K |
| 81003 |
|
897 |
856 |
$2K |
| 86255 |
|
150 |
99 |
$2K |
| 87209 |
|
111 |
105 |
$2K |
| 84165 |
|
166 |
159 |
$2K |
| 82274 |
|
106 |
104 |
$2K |
| 82565 |
|
370 |
347 |
$2K |
| 87045 |
|
207 |
191 |
$2K |
| 82550 |
|
265 |
249 |
$2K |
| 86334 |
|
74 |
71 |
$2K |
| 84100 |
|
341 |
299 |
$2K |
| 86787 |
|
142 |
118 |
$2K |
| 84450 |
|
358 |
335 |
$2K |
| 82977 |
|
196 |
186 |
$2K |
| 82785 |
|
87 |
84 |
$1K |
| 84445 |
|
30 |
29 |
$1K |
| 83615 |
|
242 |
225 |
$1K |
| 86039 |
|
124 |
114 |
$1K |
| 83883 |
|
93 |
80 |
$1K |
| 86702 |
|
96 |
94 |
$1K |
| 82247 |
|
263 |
199 |
$1K |
| 84163 |
|
77 |
76 |
$1K |
| 84460 |
|
264 |
249 |
$1K |
| 82150 |
|
180 |
174 |
$1K |
| 36416 |
|
588 |
531 |
$1K |
| 84481 |
|
159 |
155 |
$1K |
| 83010 |
|
85 |
84 |
$1K |
| 82248 |
|
226 |
205 |
$1K |
| 86147 |
|
28 |
14 |
$1K |
| 87177 |
|
113 |
107 |
$986.28 |
| 82390 |
|
86 |
84 |
$971.58 |
| 86735 |
|
77 |
73 |
$942.72 |
| 86162 |
|
42 |
39 |
$895.05 |
| 82103 |
|
60 |
59 |
$867.17 |
| 82952 |
|
216 |
207 |
$862.66 |
| 84436 |
|
113 |
111 |
$806.49 |
| 86765 |
|
63 |
62 |
$756.08 |
| 85730 |
|
138 |
130 |
$751.60 |
| 86146 |
|
26 |
13 |
$718.25 |
| 89055 |
|
173 |
159 |
$701.48 |
| 86701 |
|
75 |
74 |
$682.04 |
| 84154 |
|
35 |
33 |
$664.32 |
| 82172 |
|
69 |
68 |
$649.63 |
| 87329 |
|
53 |
50 |
$638.72 |
| 84520 |
|
163 |
154 |
$620.24 |
| 86304 |
|
28 |
27 |
$611.00 |
| 83993 |
|
32 |
31 |
$576.16 |
| 84703 |
|
74 |
69 |
$543.62 |
| 80164 |
|
32 |
31 |
$458.70 |
| 85014 |
|
182 |
173 |
$427.90 |
| 84075 |
|
109 |
103 |
$418.81 |
| 80069 |
|
65 |
64 |
$418.18 |
| 85613 |
|
41 |
34 |
$410.78 |
| 82671 |
|
13 |
13 |
$402.12 |
| 82040 |
|
100 |
93 |
$388.49 |
| 83498 |
|
13 |
13 |
$383.62 |
| 82955 |
|
37 |
35 |
$361.35 |
| 82947 |
|
110 |
108 |
$359.64 |
| 81015 |
|
126 |
117 |
$357.76 |
| 85018 |
|
149 |
142 |
$350.24 |
| 80178 |
|
49 |
46 |
$335.70 |
| 86341 |
|
15 |
13 |
$335.10 |
| 82239 |
|
19 |
15 |
$328.61 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
60 |
52 |
$324.72 |
| 84425 |
|
14 |
12 |
$311.61 |
| 84681 |
|
13 |
13 |
$305.50 |
| 84479 |
|
37 |
37 |
$264.04 |
| 86618 |
|
13 |
13 |
$249.99 |
| 84181 |
|
13 |
13 |
$249.99 |
| 85732 |
|
23 |
12 |
$248.20 |
| 83525 |
|
20 |
20 |
$232.20 |
| 82140 |
|
15 |
14 |
$230.30 |
| 86308 |
|
44 |
42 |
$223.34 |
| 85670 |
|
36 |
33 |
$221.34 |
| 86645 |
|
15 |
13 |
$209.22 |
| 86361 |
|
13 |
12 |
$207.11 |
| 86256 |
|
19 |
16 |
$204.00 |
| 86705 |
|
14 |
14 |
$172.77 |
| 82465 |
|
42 |
41 |
$166.94 |
| 82525 |
|
13 |
13 |
$158.47 |
| 85379 |
|
16 |
16 |
$151.78 |
| 86644 |
|
14 |
12 |
$148.60 |
| 81050 |
|
44 |
43 |
$142.38 |
| 85046 |
|
25 |
24 |
$138.38 |
| 84484 |
|
15 |
15 |
$135.42 |
| 82310 |
|
27 |
27 |
$132.86 |
| 85651 |
|
35 |
35 |
$132.33 |
| 87206 |
|
22 |
14 |
$116.51 |
| 82960 |
|
19 |
18 |
$116.11 |
| 89190 |
|
18 |
18 |
$96.48 |
| 86141 |
|
15 |
15 |
$89.39 |
| 86880 |
|
14 |
12 |
$66.88 |
| 84132 |
|
15 |
13 |
$66.39 |
| 85611 |
|
13 |
12 |
$57.85 |
| 81025 |
|
13 |
13 |
$46.75 |
| 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 |
183 |
106 |
$15.23 |
| 85598 |
|
12 |
12 |
$0.00 |
| 81374 |
|
13 |
13 |
$0.00 |