| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
8,052 |
1,612 |
$668K |
| D7230 |
|
1,877 |
720 |
$303K |
| D7140 |
Extraction, erupted tooth or exposed root |
4,174 |
812 |
$180K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,429 |
2,325 |
$109K |
| D0330 |
Panoramic radiographic image |
2,333 |
2,239 |
$88K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,013 |
595 |
$80K |
| D9222 |
|
326 |
303 |
$24K |
| D7240 |
Removal of impacted tooth - completely bony |
89 |
44 |
$18K |
| D7250 |
|
75 |
41 |
$8K |
| D9610 |
|
167 |
162 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
46 |
45 |
$1K |
| D9986 |
|
20 |
18 |
$3.00 |