| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99284 |
Emergency department visit for the evaluation and management, high severity |
33 |
28 |
$22K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
46 |
43 |
$13K |
| 59025 |
Fetal non-stress test |
50 |
47 |
$2K |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
18 |
13 |
$988.01 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
18 |
13 |
$988.01 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
13 |
12 |
$432.95 |