| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
4,930 |
2,640 |
$669K |
| D7140 |
Extraction, erupted tooth or exposed root |
13,008 |
3,421 |
$460K |
| D7230 |
|
3,297 |
1,823 |
$390K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,305 |
1,991 |
$214K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
7,174 |
7,060 |
$194K |
| D0140 |
Limited oral evaluation - problem focused |
9,736 |
8,821 |
$189K |
| D0330 |
Panoramic radiographic image |
5,425 |
5,293 |
$158K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,390 |
1,045 |
$151K |
| D9222 |
|
2,201 |
2,110 |
$136K |
| D0999 |
Unspecified diagnostic procedure, by report |
269 |
228 |
$56K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
2,327 |
2,265 |
$49K |
| D1999 |
|
1,819 |
1,588 |
$23K |
| D9612 |
|
731 |
707 |
$22K |
| D7220 |
|
376 |
232 |
$21K |
| D7310 |
|
99 |
40 |
$17K |
| D7250 |
|
107 |
39 |
$6K |
| D9248 |
|
95 |
90 |
$250.00 |
| D9995 |
|
14 |
13 |
$130.00 |