| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 21085 |
|
2,836 |
2,830 |
$1.40M |
| 20245 |
|
1,850 |
1,807 |
$420K |
| 76497 |
|
2,346 |
2,335 |
$310K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,566 |
1,370 |
$195K |
| D9243 |
|
1,140 |
1,104 |
$167K |
| 21030 |
|
796 |
795 |
$165K |
| 21040 |
|
696 |
695 |
$159K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
2,885 |
2,874 |
$142K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
622 |
564 |
$72K |
| D0330 |
Panoramic radiographic image |
1,910 |
1,906 |
$63K |
| 99152 |
|
1,702 |
1,695 |
$44K |
| 70355 |
|
3,063 |
3,057 |
$44K |
| D9239 |
|
536 |
518 |
$39K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,534 |
1,529 |
$33K |
| 31030 |
|
111 |
111 |
$25K |
| D9222 |
|
597 |
565 |
$23K |
| 30580 |
|
111 |
111 |
$20K |
| D0160 |
|
432 |
432 |
$12K |
| 99153 |
Mod sedat endo service >5yrs |
1,428 |
1,425 |
$10K |
| D7140 |
Extraction, erupted tooth or exposed root |
168 |
94 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
217 |
211 |
$6K |
| D7285 |
|
51 |
51 |
$4K |
| 20240 |
|
15 |
15 |
$2K |
| D7321 |
|
47 |
14 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
35 |
34 |
$405.15 |
| 70486 |
|
58 |
57 |
$221.00 |
| 99151 |
|
339 |
335 |
$0.00 |
| 21215 |
|
25 |
24 |
$0.00 |
| 21210 |
|
23 |
22 |
$0.00 |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
20 |
20 |
$0.00 |