| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
3,509 |
1,010 |
$245K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
433 |
251 |
$59K |
| D0140 |
Limited oral evaluation - problem focused |
1,249 |
1,222 |
$48K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
329 |
124 |
$28K |
| D0330 |
Panoramic radiographic image |
297 |
284 |
$19K |
| D9222 |
|
158 |
153 |
$13K |
| D7240 |
Removal of impacted tooth - completely bony |
27 |
12 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
428 |
424 |
$6K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
13 |
12 |
$168.00 |