| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,498 |
1,849 |
$532K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
419 |
418 |
$308K |
| D9310 |
|
3,119 |
3,066 |
$288K |
| D7240 |
Removal of impacted tooth - completely bony |
620 |
262 |
$195K |
| D7250 |
|
472 |
253 |
$112K |
| D7230 |
|
238 |
148 |
$58K |
| D9222 |
|
419 |
418 |
$53K |
| D0330 |
Panoramic radiographic image |
627 |
616 |
$43K |
| D0367 |
|
95 |
95 |
$26K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
185 |
183 |
$7K |
| D7140 |
Extraction, erupted tooth or exposed root |
39 |
14 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
56 |
56 |
$3K |