| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,100 |
1,198 |
$298K |
| D9222 |
|
1,230 |
1,185 |
$118K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
928 |
919 |
$52K |
| D0330 |
Panoramic radiographic image |
562 |
548 |
$48K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
195 |
195 |
$17K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
80 |
43 |
$12K |
| D7240 |
Removal of impacted tooth - completely bony |
43 |
12 |
$12K |
| D7140 |
Extraction, erupted tooth or exposed root |
39 |
12 |
$4K |
| D9610 |
|
103 |
51 |
$303.00 |
| D9219 |
|
689 |
658 |
$0.00 |
| D9612 |
|
53 |
53 |
$0.00 |