| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 69436 |
Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
1,435 |
1,053 |
$675K |
| G0330 |
Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an operating room |
73 |
58 |
$48K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
96 |
82 |
$38K |
| 42830 |
|
46 |
43 |
$19K |
| 43239 |
Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple |
80 |
49 |
$12K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
33 |
28 |
$6K |
| D7140 |
Extraction, erupted tooth or exposed root |
21 |
16 |
$0.00 |