| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
18,170 |
6,191 |
$827K |
| D7240 |
Removal of impacted tooth - completely bony |
5,191 |
1,995 |
$778K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
10,619 |
3,651 |
$653K |
| D0330 |
Panoramic radiographic image |
9,906 |
9,811 |
$311K |
| D0140 |
Limited oral evaluation - problem focused |
13,108 |
12,933 |
$199K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
4,993 |
2,853 |
$195K |
| D9222 |
|
3,428 |
3,389 |
$136K |
| D7230 |
|
1,010 |
664 |
$103K |
| D7310 |
|
672 |
288 |
$33K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
950 |
930 |
$13K |
| 70486 |
|
370 |
301 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
148 |
121 |
$6K |
| D9243 |
|
88 |
53 |
$4K |
| D9239 |
|
100 |
96 |
$3K |
| D7220 |
|
17 |
12 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45 |
39 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
57 |
54 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$479.42 |