| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
4,474 |
1,547 |
$1.31M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,063 |
1,419 |
$327K |
| D7230 |
|
1,096 |
687 |
$249K |
| D0330 |
Panoramic radiographic image |
3,432 |
3,379 |
$154K |
| D0140 |
Limited oral evaluation - problem focused |
2,538 |
2,498 |
$116K |
| D9310 |
|
1,020 |
1,006 |
$48K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
2,314 |
2,267 |
$45K |
| D7140 |
Extraction, erupted tooth or exposed root |
178 |
75 |
$24K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
157 |
157 |
$18K |
| D9222 |
|
184 |
184 |
$14K |
| D9248 |
|
30 |
30 |
$5K |
| D7111 |
|
20 |
12 |
$540.00 |