| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
3,148 |
1,023 |
$854K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,954 |
1,075 |
$256K |
| D9222 |
|
2,671 |
2,668 |
$256K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,689 |
2,605 |
$239K |
| D0140 |
Limited oral evaluation - problem focused |
6,354 |
6,329 |
$237K |
| D7140 |
Extraction, erupted tooth or exposed root |
724 |
276 |
$61K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
775 |
774 |
$37K |
| D0330 |
Panoramic radiographic image |
566 |
563 |
$27K |
| D7230 |
|
68 |
37 |
$16K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
39 |
38 |
$1K |
| D9248 |
|
13 |
13 |
$855.40 |