| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 42830 |
|
958 |
867 |
$520K |
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
2,242 |
1,817 |
$289K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
384 |
353 |
$180K |
| 88300 |
|
1,820 |
1,667 |
$579.15 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
2,502 |
2,150 |
$427.30 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,089 |
1,895 |
$282.90 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
2,398 |
2,144 |
$260.11 |
| 88304 |
|
52 |
48 |
$175.45 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
20 |
12 |
$2.98 |
| J3490 |
Unclassified drugs |
154 |
133 |
$2.11 |
| J7342 |
Instillation, ciprofloxacin otic suspension, 6 mg |
150 |
75 |
$0.00 |