| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,321 |
1,209 |
$247K |
| D9222 |
|
1,237 |
1,197 |
$137K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,381 |
670 |
$136K |
| D7240 |
Removal of impacted tooth - completely bony |
620 |
274 |
$113K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,479 |
593 |
$85K |
| D0330 |
Panoramic radiographic image |
1,513 |
1,510 |
$61K |
| D9610 |
|
1,180 |
1,153 |
$55K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
843 |
835 |
$20K |
| D7230 |
|
121 |
66 |
$17K |
| D0120 |
Periodic oral evaluation - established patient |
430 |
430 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
54 |
54 |
$1K |