| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,142 |
959 |
$163K |
| D9222 |
|
1,137 |
1,083 |
$132K |
| D7240 |
Removal of impacted tooth - completely bony |
587 |
225 |
$108K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,338 |
453 |
$76K |
| D7285 |
|
514 |
265 |
$75K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,186 |
232 |
$68K |
| D7230 |
|
448 |
208 |
$66K |
| D0330 |
Panoramic radiographic image |
756 |
739 |
$33K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
969 |
953 |
$24K |
| D7310 |
|
164 |
77 |
$16K |
| D7320 |
|
52 |
24 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
109 |
108 |
$2K |