| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2930 |
Prefabricated stainless steel crown - primary tooth |
493 |
175 |
$139K |
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
610 |
373 |
$114K |
| D2929 |
|
144 |
49 |
$41K |
| D9999 |
Unspecified adjunctive procedure, by report |
140 |
140 |
$39K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
221 |
130 |
$38K |
| D7140 |
Extraction, erupted tooth or exposed root |
225 |
125 |
$28K |
| D9222 |
|
224 |
190 |
$21K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
16 |
12 |
$2K |
| D0272 |
Bitewings - two radiographic images |
26 |
15 |
$350.15 |
| D0240 |
|
24 |
12 |
$312.22 |
| G8907 |
Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer or hospital admission upon discharge from the facility |
236 |
203 |
$0.00 |
| G8918 |
Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis |
24 |
22 |
$0.00 |