| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
2,429 |
2,287 |
$58K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
2,431 |
2,288 |
$58K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,157 |
2,029 |
$39K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
1,280 |
969 |
$32K |
| 80053 |
Comprehensive metabolic panel |
5,583 |
4,361 |
$31K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
5,872 |
4,262 |
$18K |
| 86703 |
|
1,047 |
933 |
$12K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
1,929 |
1,726 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,092 |
1,030 |
$11K |
| 87641 |
|
452 |
343 |
$11K |
| 85027 |
|
2,766 |
2,284 |
$10K |
| 87081 |
|
2,432 |
2,340 |
$10K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
1,927 |
1,280 |
$9K |
| 84443 |
Thyroid stimulating hormone (TSH) |
991 |
953 |
$9K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,225 |
2,120 |
$8K |
| 86803 |
|
829 |
738 |
$8K |
| 81003 |
|
3,830 |
3,158 |
$7K |
| 87624 |
Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types |
468 |
461 |
$7K |
| 81511 |
|
102 |
90 |
$6K |
| 83874 |
|
844 |
638 |
$6K |
| 80061 |
Lipid panel |
1,817 |
1,723 |
$6K |
| 87210 |
|
1,278 |
1,153 |
$6K |
| 82962 |
|
1,889 |
626 |
$6K |
| 87340 |
|
799 |
716 |
$6K |
| 84484 |
|
1,036 |
717 |
$6K |
| 82553 |
|
1,006 |
686 |
$6K |
| 87040 |
|
426 |
286 |
$5K |
| 87653 |
|
227 |
180 |
$5K |
| 83735 |
|
1,319 |
736 |
$5K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
911 |
864 |
$5K |
| 87536 |
|
110 |
97 |
$5K |
| 87902 |
|
59 |
44 |
$4K |
| 82607 |
|
624 |
547 |
$4K |
| 87522 |
Neg quan hep c or qual rna |
145 |
122 |
$4K |
| 83655 |
|
511 |
477 |
$4K |
| 87186 |
|
570 |
486 |
$4K |
| 85610 |
|
1,503 |
967 |
$4K |
| 83690 |
|
913 |
700 |
$4K |
| 87807 |
|
492 |
416 |
$4K |
| 81025 |
|
1,864 |
1,633 |
$4K |
| 82746 |
|
557 |
474 |
$4K |
| 87077 |
|
430 |
342 |
$4K |
| 83605 |
|
521 |
342 |
$4K |
| 86706 |
|
407 |
349 |
$3K |
| 86592 |
|
1,145 |
1,007 |
$3K |
| 86704 |
|
359 |
311 |
$3K |
| 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 |
134 |
95 |
$3K |
| 83880 |
|
335 |
247 |
$3K |
| 82805 |
|
375 |
187 |
$3K |
| 86901 |
|
908 |
742 |
$3K |
| 83550 |
|
505 |
446 |
$3K |
| 86850 |
|
732 |
610 |
$3K |
| 83021 |
|
394 |
334 |
$2K |
| 84439 |
|
481 |
434 |
$2K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
105 |
76 |
$2K |
| 86141 |
|
268 |
194 |
$2K |
| 85730 |
|
587 |
460 |
$2K |
| 86003 |
|
144 |
120 |
$2K |
| 83540 |
|
520 |
465 |
$2K |
| 86708 |
|
356 |
305 |
$2K |
| 86900 |
|
814 |
687 |
$2K |
| 80074 |
|
101 |
76 |
$2K |
| 82570 |
|
641 |
555 |
$2K |
| 86762 |
|
401 |
339 |
$2K |
| 82728 |
|
417 |
369 |
$2K |
| 82550 |
|
449 |
263 |
$2K |
| 87529 |
|
61 |
47 |
$2K |
| 83970 |
|
107 |
80 |
$2K |
| 84100 |
|
541 |
261 |
$2K |
| 86038 |
|
193 |
161 |
$2K |
| 82043 |
|
496 |
440 |
$1K |
| 86481 |
|
54 |
54 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
50 |
49 |
$1K |
| 83516 |
|
238 |
213 |
$1K |
| 85379 |
|
265 |
201 |
$1K |
| 87449 |
|
116 |
92 |
$1K |
| 84153 |
|
122 |
93 |
$969.84 |
| 82950 |
|
338 |
297 |
$968.77 |
| 84146 |
|
139 |
101 |
$959.08 |
| 87070 |
|
253 |
198 |
$943.72 |
| 84132 |
|
220 |
134 |
$935.90 |
| 82105 |
|
107 |
88 |
$928.64 |
| 85652 |
|
438 |
362 |
$922.21 |
| 80076 |
|
196 |
159 |
$887.51 |
| 84481 |
|
160 |
117 |
$832.17 |
| 85018 |
|
408 |
374 |
$826.51 |
| 82784 |
|
116 |
102 |
$805.55 |
| 83001 |
|
78 |
55 |
$748.01 |
| 84403 |
|
58 |
46 |
$737.90 |
| 86376 |
|
154 |
117 |
$727.55 |
| 83721 |
|
173 |
141 |
$726.25 |
| 82274 |
|
111 |
108 |
$700.00 |
| 82261 |
|
83 |
75 |
$695.63 |
| 87205 |
|
277 |
216 |
$689.49 |
| 87338 |
|
66 |
60 |
$656.45 |
| 87806 |
|
65 |
59 |
$628.85 |
| 87324 |
|
80 |
65 |
$628.00 |
| 82785 |
|
133 |
113 |
$592.09 |
| 87427 |
|
91 |
77 |
$589.27 |
| 86778 |
|
61 |
40 |
$582.80 |
| 82775 |
|
83 |
75 |
$562.75 |
| 82465 |
|
232 |
193 |
$561.04 |
| 87045 |
|
86 |
74 |
$560.69 |
| 81002 |
|
371 |
301 |
$527.75 |
| 84270 |
|
62 |
46 |
$515.99 |
| 87184 |
|
106 |
75 |
$511.26 |
| 86361 |
|
104 |
91 |
$509.25 |
| 82150 |
|
124 |
80 |
$504.98 |
| 82017 |
|
86 |
78 |
$504.62 |
| 82139 |
|
84 |
76 |
$493.29 |
| 83883 |
|
73 |
53 |
$492.68 |
| 84550 |
|
192 |
133 |
$465.09 |
| 82951 |
|
67 |
55 |
$457.68 |
| 86430 |
|
137 |
106 |
$450.13 |
| 80164 |
|
84 |
59 |
$416.11 |
| 86777 |
|
74 |
49 |
$412.75 |
| 84480 |
|
88 |
63 |
$412.52 |
| 83498 |
|
90 |
80 |
$405.63 |
| 82248 |
|
183 |
114 |
$362.12 |
| 84156 |
|
203 |
137 |
$351.41 |
| 83615 |
|
96 |
51 |
$332.86 |
| 82977 |
|
116 |
75 |
$326.89 |
| 82247 |
|
164 |
104 |
$314.41 |
| 86870 |
|
41 |
27 |
$308.32 |
| 82565 |
|
105 |
78 |
$304.96 |
| 86308 |
|
100 |
76 |
$303.00 |
| 86800 |
|
49 |
37 |
$284.30 |
| 87075 |
|
48 |
36 |
$279.40 |
| 84437 |
|
81 |
73 |
$262.78 |
| 86880 |
|
88 |
80 |
$257.55 |
| 85045 |
|
139 |
98 |
$247.47 |
| 83013 |
|
52 |
49 |
$245.59 |
| 84436 |
|
61 |
45 |
$231.97 |
| 80069 |
|
50 |
13 |
$213.00 |
| 82140 |
|
50 |
20 |
$206.53 |
| 86140 |
|
68 |
41 |
$189.82 |
| 86694 |
|
19 |
12 |
$186.79 |
| 80202 |
|
26 |
13 |
$186.36 |
| 86696 |
|
16 |
15 |
$174.57 |
| 84460 |
|
67 |
49 |
$173.41 |
| 80177 |
|
32 |
24 |
$161.82 |
| 80305 |
|
35 |
24 |
$161.64 |
| 83930 |
|
63 |
46 |
$158.44 |
| 89051 |
|
46 |
32 |
$147.08 |
| 87102 |
|
41 |
29 |
$144.26 |
| 87046 |
|
90 |
77 |
$136.45 |
| 86787 |
|
16 |
12 |
$127.50 |
| 86885 |
|
39 |
27 |
$124.37 |
| 80185 |
|
18 |
12 |
$122.00 |
| 84300 |
|
37 |
27 |
$117.91 |
| 84144 |
|
20 |
16 |
$96.63 |
| 84450 |
|
40 |
29 |
$95.07 |
| 83002 |
|
19 |
12 |
$89.86 |
| 82670 |
|
15 |
13 |
$75.90 |
| 84520 |
|
23 |
15 |
$70.04 |
| 83935 |
|
19 |
13 |
$44.27 |
| 82272 |
|
36 |
27 |
$37.74 |
| 82945 |
|
15 |
14 |
$34.60 |
| 85014 |
|
24 |
13 |
$27.84 |
| 84160 |
|
18 |
13 |
$22.27 |
| 80329 |
|
124 |
91 |
$0.00 |
| 80050 |
General health panel |
279 |
269 |
$0.00 |
| 80320 |
|
327 |
224 |
$0.00 |
| 86923 |
|
44 |
27 |
$0.00 |