| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
5,586 |
1,550 |
$967K |
| D7240 |
Removal of impacted tooth - completely bony |
2,993 |
964 |
$934K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,923 |
1,606 |
$417K |
| D0140 |
Limited oral evaluation - problem focused |
4,678 |
4,492 |
$226K |
| D9222 |
|
1,684 |
1,580 |
$220K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,671 |
578 |
$165K |
| D0330 |
Panoramic radiographic image |
1,533 |
1,471 |
$117K |
| D7280 |
|
227 |
152 |
$43K |
| D9610 |
|
950 |
903 |
$27K |
| D9612 |
|
193 |
187 |
$12K |
| D7283 |
|
59 |
41 |
$10K |
| D7230 |
|
23 |
12 |
$6K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
55 |
53 |
$3K |