| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
129 |
74 |
$6K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
129 |
74 |
$6K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
162 |
104 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
35 |
31 |
$2K |
| 81001 |
|
181 |
103 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
69 |
28 |
$686.39 |
| 85652 |
|
87 |
39 |
$341.35 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
47 |
45 |
$307.80 |
| 36415 |
Collection of venous blood by venipuncture |
106 |
79 |
$157.20 |
| 81025 |
|
15 |
14 |
$132.75 |