| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 66984 |
Extracapsular cataract removal with insertion of intraocular lens prosthesis |
1,327 |
1,032 |
$466K |
| D9999 |
Unspecified adjunctive procedure, by report |
200 |
197 |
$194K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
183 |
50 |
$54K |
| D2390 |
|
48 |
12 |
$16K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
72 |
25 |
$13K |
| D1120 |
Prophylaxis - child |
29 |
13 |
$589.68 |
| D1206 |
Topical application of fluoride varnish |
32 |
13 |
$406.98 |
| V2632 |
Posterior chamber intraocular lens |
230 |
188 |
$0.00 |
| 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 |
143 |
127 |
$0.00 |
| G8918 |
Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis |
114 |
103 |
$0.00 |