| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7230 |
|
1,326 |
577 |
$82K |
| D0140 |
Limited oral evaluation - problem focused |
2,717 |
2,678 |
$35K |
| D7240 |
Removal of impacted tooth - completely bony |
262 |
122 |
$12K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
113 |
80 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
607 |
596 |
$2K |
| D0330 |
Panoramic radiographic image |
26 |
26 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
440 |
179 |
$1K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
16 |
15 |
$266.34 |
| D9222 |
|
17 |
16 |
$266.34 |
| D0707 |
|
15 |
14 |
$29.76 |