| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
6,128 |
748 |
$528K |
| D7240 |
Removal of impacted tooth - completely bony |
1,000 |
372 |
$229K |
| D9243 |
|
1,039 |
658 |
$138K |
| D7230 |
|
431 |
199 |
$78K |
| D9239 |
|
507 |
497 |
$48K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
927 |
905 |
$43K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
140 |
93 |
$17K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
177 |
170 |
$9K |
| D9222 |
|
64 |
64 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
44 |
14 |
$3K |