| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
4,303 |
1,103 |
$596K |
| D9310 |
|
1,774 |
1,749 |
$163K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,519 |
375 |
$126K |
| D0330 |
Panoramic radiographic image |
1,692 |
1,667 |
$101K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,127 |
425 |
$80K |
| D7240 |
Removal of impacted tooth - completely bony |
306 |
136 |
$77K |
| D9222 |
|
432 |
425 |
$31K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
356 |
345 |
$14K |
| D7230 |
|
15 |
12 |
$3K |