| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
7,980 |
2,350 |
$562K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,838 |
931 |
$293K |
| D7240 |
Removal of impacted tooth - completely bony |
1,542 |
536 |
$272K |
| D7230 |
|
856 |
349 |
$132K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,475 |
2,431 |
$91K |
| D9610 |
|
2,413 |
2,344 |
$84K |
| D7250 |
|
820 |
276 |
$83K |
| D7311 |
|
680 |
346 |
$59K |
| D0330 |
Panoramic radiographic image |
2,556 |
2,420 |
$31K |
| D7510 |
|
149 |
70 |
$5K |
| D9110 |
|
106 |
99 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
13 |
12 |
$413.96 |
| D0120 |
Periodic oral evaluation - established patient |
25 |
25 |
$205.48 |
| D9630 |
|
1,567 |
1,518 |
$0.00 |