| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
25,302 |
3,475 |
$1.55M |
| D9222 |
|
2,915 |
2,882 |
$343K |
| D7240 |
Removal of impacted tooth - completely bony |
1,375 |
587 |
$270K |
| D7230 |
|
1,488 |
719 |
$243K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,453 |
1,436 |
$196K |
| D0140 |
Limited oral evaluation - problem focused |
3,097 |
3,088 |
$142K |
| D0330 |
Panoramic radiographic image |
1,417 |
1,409 |
$49K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
759 |
503 |
$47K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
735 |
685 |
$13K |
| D0120 |
Periodic oral evaluation - established patient |
323 |
304 |
$6K |
| D9930 |
|
373 |
369 |
$6K |