| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
6,625 |
2,709 |
$1.52M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
8,845 |
2,879 |
$1.04M |
| D7230 |
|
4,078 |
2,243 |
$768K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
4,584 |
3,139 |
$764K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
8,585 |
8,549 |
$559K |
| D9222 |
|
3,144 |
3,140 |
$379K |
| D0330 |
Panoramic radiographic image |
8,694 |
8,658 |
$258K |
| D9220 |
|
798 |
780 |
$174K |
| D9221 |
|
812 |
759 |
$86K |
| D7220 |
|
408 |
317 |
$56K |
| D9430 |
|
857 |
771 |
$27K |
| D7140 |
Extraction, erupted tooth or exposed root |
444 |
134 |
$25K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
341 |
337 |
$13K |
| D7251 |
|
40 |
25 |
$5K |