| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
429 |
131 |
$119K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
128 |
115 |
$66K |
| D9222 |
|
150 |
131 |
$62K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
130 |
57 |
$60K |
| D7140 |
Extraction, erupted tooth or exposed root |
619 |
135 |
$49K |
| D0330 |
Panoramic radiographic image |
197 |
159 |
$27K |
| D7240 |
Removal of impacted tooth - completely bony |
119 |
45 |
$22K |
| D9243 |
|
400 |
113 |
$22K |
| D0140 |
Limited oral evaluation - problem focused |
203 |
201 |
$13K |
| D7230 |
|
23 |
12 |
$3K |
| D9239 |
|
147 |
88 |
$2K |
| D0210 |
Intraoral - complete series of radiographic images |
13 |
13 |
$1K |