| Code | Description | Claims | Beneficiaries | Total Paid |
| 80053 |
Comprehensive metabolic panel |
902 |
571 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
76 |
74 |
$985.68 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,005 |
610 |
$516.60 |
| 84484 |
|
112 |
78 |
$359.12 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
82 |
78 |
$120.90 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
58 |
58 |
$78.46 |
| 81001 |
|
168 |
151 |
$45.94 |
| 87081 |
|
73 |
72 |
$26.66 |
| 81003 |
|
27 |
25 |
$4.49 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
14 |
13 |
$2.82 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15 |
13 |
$2.60 |
| 81025 |
|
28 |
28 |
$2.10 |
| 83690 |
|
30 |
25 |
$1.13 |
| 85610 |
|
16 |
15 |
$0.57 |
| 87428 |
|
82 |
81 |
$0.00 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
97 |
12 |
$0.00 |