| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,202 |
674 |
$566K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,499 |
641 |
$315K |
| D9222 |
|
660 |
645 |
$300K |
| D7240 |
Removal of impacted tooth - completely bony |
353 |
154 |
$154K |
| D0140 |
Limited oral evaluation - problem focused |
1,288 |
1,260 |
$110K |
| D9612 |
|
835 |
816 |
$97K |
| D7140 |
Extraction, erupted tooth or exposed root |
358 |
82 |
$58K |
| D0330 |
Panoramic radiographic image |
355 |
347 |
$21K |
| D9239 |
|
25 |
24 |
$10K |
| D7230 |
|
21 |
13 |
$8K |
| D9243 |
|
30 |
12 |
$6K |
| D9610 |
|
68 |
66 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
26 |
25 |
$2K |
| D9999 |
Unspecified adjunctive procedure, by report |
406 |
396 |
$2K |