| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,211 |
134 |
$46K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
752 |
110 |
$9K |
| D7220 |
|
188 |
61 |
$8K |
| D9310 |
|
156 |
128 |
$6K |
| D7311 |
|
427 |
114 |
$6K |
| D9222 |
|
156 |
89 |
$6K |
| D0330 |
Panoramic radiographic image |
323 |
216 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
311 |
157 |
$5K |
| D7250 |
|
111 |
28 |
$5K |
| D7240 |
Removal of impacted tooth - completely bony |
100 |
27 |
$5K |
| D7140 |
Extraction, erupted tooth or exposed root |
78 |
13 |
$3K |
| D7310 |
|
76 |
14 |
$2K |
| D9612 |
|
199 |
108 |
$2K |
| D7970 |
|
148 |
46 |
$738.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
48 |
29 |
$442.56 |
| D7511 |
|
88 |
37 |
$362.44 |
| D7960 |
|
36 |
15 |
$246.00 |