| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,287 |
1,191 |
$420K |
| D0330 |
Panoramic radiographic image |
1,581 |
1,575 |
$120K |
| D7240 |
Removal of impacted tooth - completely bony |
235 |
86 |
$98K |
| D0140 |
Limited oral evaluation - problem focused |
1,782 |
1,776 |
$94K |
| D9222 |
|
453 |
449 |
$44K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
284 |
282 |
$40K |
| D7140 |
Extraction, erupted tooth or exposed root |
17 |
12 |
$2K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
60 |
59 |
$1K |
| D9610 |
|
202 |
193 |
$520.00 |