Appendix B - Technical Exhibit 2 - Attachment A.xlsx
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NPL
| Test name | CPT code | Qty (Sum) | Base year Cost/test | Base year Total | Option YR#1 Cost/test | Option YR#1 Total | Option YR#2 Cost/test | Option YR#2 Total | Option YR#3 Cost/test | Option YR#3 Total | Option YR#4 Cost/test | Option YR#4 Total |
| CHLAMYDIA/N GONORRHEA AMPLIFIED | MULTIPLE | 9,261 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| VITAMIN D 25 | 82306 | 7,645 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| RPR | 86592 | 6,553 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, URINE ISO & COL COUNT | 87086 | 5,772 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SUSC, MIC | 87186 | 4,887 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TSH | 84443 | 4,834 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEP C AB | 86803 | 4,827 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| MAB/CREATININE, URINE | MULTIPLE | 3,566 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, THROAT | 87070 | 3,432 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, IMMUNE | 87147 | 3,289 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| T4, FREE | 84439 | 3,044 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| BLOOD CULTURE | 87040 | 3,001 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| DRUG PANEL URINE COMPREHENSIVE | MULTIPLE | 3,018 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CBC W/AUTOMATED DIFF | 85025 | 2,499 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PAP, THIN PREP IMAGED | 88175 | 2,489 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HIV-1, 2 COMBO AG/AB | 87389 | 2,440 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HIV COMBO AG/AB WITH REFLEX | 87389 | 2,437 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEMOGLOBIN A1C | 83036 | 2,358 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| VITAMIN B12 | 82607 | 2,253 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEP B SURFACE AG | 87340 | 2,178 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, AEROBE ID | 87077 | 1,960 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CHEMISTRY PANEL, COMPREHENSIVE | 80053 | 1,864 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEPATITIS PANEL ACUTE, WITH REFLEX | 80074 | 1,859 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HPV DNA PROBE HI RISK ONLY | 87624 | 1,761 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, URINE, PRESUMPT ID | 87088 | 1,575 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| GRAM STAIN | 87205 | 1,465 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LIPID PANEL | 80061 | 1,454 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, MISC (GS ADDTL) | 87070 | 1,325 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PRENATE PANELW/HBS AG | MULTIPLE | 1,173 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| AEROBIC BACTERIAL ID | 87077 | 1,054 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ANA SCRN REFLEX | 86038 | 906 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PSA, SCRN | 84153 | 898 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| URINALYSIS W/MICRO EXAM | 81001 | 865 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| MAGNESIUM, SERUM | 83735 | 864 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TISSUE EXAM, LEVEL IV (G) | 88305 | 823 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FERRITIN | 82728 | 808 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| RHEUMATOID FACTOR | 86431 | 764 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEP C RNA QNT PCR | 87522 | 716 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CRP | 86140 | 712 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, GROUP B | 87081 | 626 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| IRON & IRON BINDING CAPACITY | MULTIPLE | 598 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FOLATE, SERUM | 82746 | 562 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| RPR TITER | 86593 | 531 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| T. PALLIDUM (MHA-TP) | 86780 | 523 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| IRON PANEL | MULTIPLE | 511 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PTH INTACT W/CALCIUM | MULTIPLE | 494 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CYCLIC CITR AB, IgG | 86200 | 468 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEP B SURFACE AB | 86317 | 468 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| URINALYSIS ROUTINE | 81003 | 457 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TACROLIMUS (FK506) | 80197 | 446 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| MATERNAL SERUM, QUAD | 81511 | 435 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| H PYLORI AG, FECES | 87338 | 420 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| URINE PROTEIN/CREATININE RATIO | MULTIPLE | 401 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SARS-COV-2 | U0003 | 414 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEP A AB, IgM | 86709 | 379 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| WBC DIFF, MANUAL | 85007 | 372 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| KEPPRA | 80177 | 327 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SUSC, KIRBY BAUER | 87184 | 322 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| URIC ACID, SERUM | 84550 | 321 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| DSCR - DRUG SCREEN PER ENCOUNTER (individual) | 80307 | 318 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEP B CORE AB, | 86704 | 303 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| C DIFFICILE TOXIN BY PCR | 87493 | 282 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| DSDNA AUTOAB IGG | 86225 | 273 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PROTHROMBIN TIME | 85610 | 261 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HPV GENOTYPE 16, 18/45 | 87625 | 259 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FSH | 83001 | 249 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| COMPLEMENT C4 | 86160 | 247 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LEAD CAPILLARY | 83655 | 247 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| DRUG CONFIRM, MARIJUANA | 80349 | 246 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PHOSPHORUS, SERUM | 84100 | 244 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| COMPLEMENT C3 | 86160 | 242 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LEAD, BLOOD VENOUS | 83655 | 232 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SSA (RO) AUTOAB IGG | 86235 | 222 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SSB (LA) AUTOAB IGG | 86235 | 222 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SM AUTOAB IGG | 86235 | 219 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| RNP AUTOAB IGG | 86235 | 218 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| QUANTIFERON GOLD | 86480 | 214 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| JO-1 AUTOAB IGG | 86235 | 213 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CENTROMERE B AUTOAB IGG | 86235 | 212 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SCL 70 AUTOAB IGG | 86235 | 210 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CHROMATIN AUTOAB IGG | 86235 | 209 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| RIBOSOMAL P AUTOAB IGG | 86235 | 209 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SMRNP AUTOAB IGG | 86235 | 209 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| hCG, QNT | 84702 | 204 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HSV 1/2 ABS, IgG/IgM | MULTIPLE | 201 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PROLACTIN | 84146 | 199 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ABO & RH | MULTIPLE | 187 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CHEMISTRY PANEL, BASIC | 80048 | 185 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| B-NATRIURETC PEPTD | 83880 | 174 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TESTOSTERONE FREE & total (male/female/child) | MULTIPLE | 173 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| AFP TUMOR MARKER | 82105 | 171 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LUTEINIZING HORMONE, SERUM | 83002 | 171 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PROTEIN, URINE | 84156 | 170 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| BLOOD SMEAR TO PATHOLOGIST | 85060 | 168 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| GLUCOSE, PREG 1 HR | 82950 | 167 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEP C RNA GENOTYPE | 87902 | 164 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HSV 1 GLYCO, IgG | 86695 | 164 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HSV 2 GLYCO, IgG | 86696 | 164 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, STOOL | MULTIPLE | 156 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, ENVIRONMENT | 87070 | 149 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| VARICELLA ZOSTER AB, IgG | 86787 | 148 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| T3, FREE | 84481 | 144 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CRYPTO/GIARDIA by IMMUNOASSAY | MULTIPLE | 138 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEP A ABS, | 86708 | 135 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CREATININE CLEARANCE | 82575 | 133 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ANTIBODY SCRN | 86850 | 132 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CK, | 82550 | 132 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, ID NONPURE | MULTIPLE | 131 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TISSUE TRANSGLUTAMINASE AB, IgA | 83516 | 131 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ANA SCREEN | 86038 | 127 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PRENATAL PANEL | MULTIPLE | 125 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| T3, | 84480 | 121 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PAP, THIN PREP | 88142 | 120 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| BLOOD CULTURE ID PROCESSING/SET-UP | MULTIPLE | 117 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| VITAMIN D 1,25 | 82652 | 117 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| VALPROIC ACID | 80164 | 114 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FECES CULTURE WITH SHIGA TOXIN | MULTIPLE | 107 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TISSUE EXAM, LEVEL III (G) | 88304 | 107 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| AMMONIA | 82140 | 106 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| 25-HYDROXYVITAMIN D2 & D3 | 82306 | 105 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| STAIN, IMMUNOHISTOCHEMICAL (G) | 88342 | 104 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| INSULIN | 83525 | 103 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HSV AMPLIFIED MOLECULAR | MULTIPLE | 102 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PARTIAL THROM (PTT) | 85730 | 102 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| RUBELLA SCRN, IgG | 86762 | 102 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ESTRADIOL | 82670 | 99 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| VARICELLA ZOSTER ABS, IgG/IgM | MULTIPLE | 98 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PRENATAL PANEL W HBSAG/ SERUM HIV | MULTIPLE | 94 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| GGT | 82977 | 92 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| MEASLES AB, IgG | 86765 | 92 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| MUMPS VIR AB, IgG | 86735 | 92 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PROTEIN ELP, SERUM | 84165 | 92 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TESTOSTERONE, Total | 84403 | 90 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| THYROID ABS | MULTIPLE | 90 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ABO, RH & AB SCRN | MULTIPLE | 88 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| BK VIRUS, QUANT, PCR | 87799 | 85 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| IgA GAMMA | 82784 | 81 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LYME DISEASE ABS | 86618 | 81 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LIPASE | 83690 | 79 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PROGESTERONE | 84144 | 79 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CORTISOL | 82533 | 77 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| IFOB | 82274 | 74 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| VIRAL RESPIRATORY PANEL | MULTIPLE | 74 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ANTIBODY ID | 86870 | 72 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CANCER AG 125 | 86304 | 72 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, MRSA PBP2 | 87147 | 72 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, ANAER/AEROBE (GS ADDTL) | MULTIPLE | 68 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ERYTHROCYTE SEDIMENTATION RATE (ESR), AUTOMATED | 85652 | 68 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HEPATIC FUNCTION PANEL | 80076 | 68 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| MONONUCLEOSIS SCRN | 86308 | 67 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| RETICULOCYTE COUNT, AUTOMATED | 85046 | 67 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HIV-1 RNA, BY QNT NAAT | 87536 | 66 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| GABAPENTIN/NEURONTIN | 80171 | 65 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LDL, DIRECT | 83721 | 64 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| DRUG PANEL, MECONIUM, SINGLE DRUG | 80307 | 62 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LITHIUM | 80178 | 60 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| B-HYDROXYBUTYRATE | 82010 | 58 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| GIARDIA ANTIGEN | 87329 | 58 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| PREGNANCY, URINE | 81025 | 58 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| BODY FLUID CELL COUNT WITH DIFFERENTIAL | 89051 | 57 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FOLATE, RBC | 82747 | 56 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| NEUTROPHIL CYTOPLASMIC AB, IgG | 86255 | 56 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| TISSUE EXAM, LEVEL V (G) | 88307 | 56 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, ANEROBE ONLY | 87075 | 55 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| AMPHETAMINE, QUANT | 80324 | 54 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LAMOTRIGINE/LAMICTAL | 80175 | 54 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SODIUM, URINE | 84300 | 54 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| C DIFF TOXIN BY IMMUNOASSAY | 87324 | 53 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CEA | 82378 | 53 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CMV DNA, QUANT BY PCR | 87497 | 53 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| HLA-B27 | 86812 | 52 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SUSC, E-TEST | 87181 | 52 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CARDIOLIPIN AB, IgG/IgM | MULTIPLE | 51 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ROTAVIRUS ANTIGEN | 87425 | 50 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SARS-COV-2 IGG AB | 86769 | 45 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CREATININE, URINE | 82570 | 44 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CARBAMAZEPINE, | 80156 | 43 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| DOA MECONIUM CANNABINOIDS CONFIRMATION | 80349 | 43 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| C-PEPTIDE, SERUM | 84681 | 42 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, ANAEROBE ID | 87076 | 42 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, RESP (GS ADDTL) | 87070 | 42 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ESTROGENS, FRACTIONATED | 82671 | 42 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| DHEA S | 82627 | 41 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| MONOCLONAL PROTEIN STUDY | MULTIPLE | 41 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SHIGATOXIN | MULTIPLE | 41 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| VAGINAL PATHOGENS | MULTIPLE | 40 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| F-ACTIN SMOOTH MUSCLE AB | 83516 | 39 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CROSSMATCH, COOMBS | 86922 | 38 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| AMYLASE, SERUM | 82150 | 37 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CULTURE, MRSA (NEG) | 87081 | 37 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ZINC SERUM | 84630 | 37 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| EVEROLIMUS | 80169 | 36 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| IMMUNOGLOBULIN A | 82784 | 36 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| LD | 83615 | 36 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| SUSC, E-TEST 2 | 87181 | 36 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| T4, | 84436 | 36 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| ALLERGEN, REGION 9 RESPIRATORY PANEL | MULTIPLE | 35 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CROSSMATCH, IMMEDIATE SPIN | 86920 | 35 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| CROSSMATCH, INCUBATED | 86921 | 35 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| FECAL LACTOFERRIN | 83630 | 35 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | |||||
| Total for yeach year | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
File details come from the government source that posted it. Updated .