| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 82670 |
|
19 |
16 |
$363.23 |
| 84403 |
|
18 |
15 |
$335.54 |
| 84402 |
|
19 |
16 |
$331.12 |
| 84143 |
|
19 |
16 |
$296.54 |
| 82627 |
|
19 |
16 |
$289.00 |
| 84146 |
|
18 |
15 |
$251.95 |
| 83002 |
|
19 |
16 |
$240.77 |
| 83003 |
|
19 |
16 |
$216.72 |
| 82533 |
|
19 |
16 |
$211.91 |
| 82607 |
|
18 |
15 |
$196.04 |
| 82746 |
|
18 |
15 |
$191.10 |
| 82728 |
|
18 |
15 |
$177.19 |
| 80061 |
Lipid panel |
18 |
15 |
$174.07 |
| 84443 |
Thyroid stimulating hormone (TSH) |
18 |
15 |
$168.01 |
| 84466 |
|
18 |
15 |
$165.88 |
| 84481 |
|
18 |
15 |
$156.26 |
| 83525 |
|
18 |
15 |
$148.59 |
| 82652 |
|
18 |
15 |
$123.13 |
| 84439 |
|
18 |
15 |
$117.26 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
18 |
15 |
$116.52 |
| 80053 |
Comprehensive metabolic panel |
18 |
15 |
$105.60 |
| 82977 |
|
18 |
15 |
$93.60 |
| 83735 |
|
18 |
15 |
$87.10 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
20 |
16 |
$85.47 |
| 82150 |
|
18 |
15 |
$84.24 |
| 83540 |
|
18 |
15 |
$82.42 |
| 84270 |
|
19 |
16 |
$81.12 |
| 83615 |
|
19 |
16 |
$78.52 |
| 86431 |
|
19 |
16 |
$73.71 |
| 86140 |
|
19 |
16 |
$67.34 |
| 82248 |
|
18 |
15 |
$62.92 |
| 84100 |
|
18 |
15 |
$61.62 |
| 84550 |
|
18 |
15 |
$58.76 |
| 36415 |
Collection of venous blood by venipuncture |
123 |
99 |
$48.39 |
| 72100 |
|
13 |
12 |
$28.24 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
35 |
29 |
$8.46 |
| 77003 |
|
1,215 |
902 |
$0.00 |
| 64636 |
|
719 |
195 |
$0.00 |
| 64495 |
|
23 |
12 |
$0.00 |
| 64634 |
|
48 |
12 |
$0.00 |
| 00000 |
|
289 |
231 |
$0.00 |
| 64635 |
|
279 |
230 |
$0.00 |
| 64494 |
|
108 |
40 |
$0.00 |
| 64493 |
|
196 |
121 |
$0.00 |
| 64633 |
|
16 |
12 |
$0.00 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
14 |
14 |
$0.00 |