| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 81408 |
|
977 |
970 |
$20K |
| 81407 |
|
946 |
942 |
$4K |
| 81405 |
|
973 |
966 |
$2K |
| 81406 |
|
973 |
966 |
$2K |
| 81404 |
|
945 |
939 |
$2K |
| 81403 |
|
946 |
942 |
$1K |
| 81401 |
|
975 |
970 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,676 |
1,411 |
$121.95 |
| 80053 |
Comprehensive metabolic panel |
1,280 |
1,118 |
$113.59 |
| 84443 |
Thyroid stimulating hormone (TSH) |
591 |
549 |
$112.30 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
666 |
549 |
$63.89 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
545 |
446 |
$42.90 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
138 |
118 |
$27.63 |
| 80061 |
Lipid panel |
560 |
502 |
$26.79 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
330 |
240 |
$25.11 |
| 80164 |
|
121 |
115 |
$15.61 |
| 84134 |
|
14 |
13 |
$15.13 |
| 81001 |
|
527 |
417 |
$13.16 |
| 81003 |
|
28 |
27 |
$0.00 |
| 84439 |
|
20 |
20 |
$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 |
3,016 |
2,035 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,086 |
2,079 |
$0.00 |
| 87181 |
|
13 |
12 |
$0.00 |
| 80177 |
|
41 |
40 |
$0.00 |
| 83735 |
|
18 |
17 |
$0.00 |
| 82043 |
|
13 |
13 |
$0.00 |
| 83880 |
|
24 |
17 |
$0.00 |
| 87070 |
|
12 |
12 |
$0.00 |