| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
43,349 |
10,082 |
$2.53M |
| D7240 |
Removal of impacted tooth - completely bony |
3,676 |
1,611 |
$907K |
| D9222 |
|
5,971 |
5,863 |
$586K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
4,768 |
2,656 |
$393K |
| D0140 |
Limited oral evaluation - problem focused |
11,290 |
11,013 |
$284K |
| D7230 |
|
1,482 |
763 |
$273K |
| D9310 |
|
6,185 |
6,106 |
$224K |
| D0330 |
Panoramic radiographic image |
3,090 |
3,036 |
$112K |
| D1110 |
Prophylaxis - adult |
2,430 |
2,384 |
$96K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
727 |
409 |
$71K |
| D0210 |
Intraoral - complete series of radiographic images |
1,473 |
1,427 |
$59K |
| D0120 |
Periodic oral evaluation - established patient |
1,931 |
1,904 |
$37K |
| D0220 |
Intraoral - periapical first radiographic image |
2,446 |
2,378 |
$25K |
| D7310 |
|
167 |
56 |
$16K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
425 |
415 |
$9K |
| D1206 |
Topical application of fluoride varnish |
497 |
492 |
$7K |
| D0274 |
Bitewings - four radiographic images |
248 |
246 |
$4K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
33 |
27 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
344 |
204 |
$2K |
| 70486 |
|
40 |
36 |
$1K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
23 |
15 |
$1K |
| D9420 |
|
25 |
25 |
$747.39 |
| 70355 |
|
12 |
12 |
$298.93 |
| D0602 |
|
27 |
27 |
$130.00 |
| D0270 |
|
15 |
15 |
$117.42 |