| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
12,908 |
6,439 |
$1.35M |
| D7240 |
Removal of impacted tooth - completely bony |
3,499 |
1,230 |
$882K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,220 |
1,870 |
$556K |
| D7230 |
|
2,579 |
1,290 |
$531K |
| D0140 |
Limited oral evaluation - problem focused |
16,199 |
15,537 |
$491K |
| D9222 |
|
2,121 |
1,857 |
$184K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
5,040 |
4,727 |
$178K |
| D0330 |
Panoramic radiographic image |
3,014 |
2,875 |
$167K |
| D7250 |
|
601 |
268 |
$88K |
| D7140 |
Extraction, erupted tooth or exposed root |
753 |
297 |
$51K |
| D7220 |
|
282 |
188 |
$43K |
| D0220 |
Intraoral - periapical first radiographic image |
145 |
136 |
$1K |
| D1999 |
|
676 |
615 |
$0.00 |