| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
4,551 |
1,754 |
$624K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
5,868 |
1,763 |
$447K |
| D7250 |
|
1,250 |
368 |
$168K |
| D7240 |
Removal of impacted tooth - completely bony |
553 |
202 |
$162K |
| D0330 |
Panoramic radiographic image |
2,232 |
2,148 |
$152K |
| D9222 |
|
1,611 |
1,461 |
$123K |
| D0140 |
Limited oral evaluation - problem focused |
3,166 |
3,006 |
$114K |
| D0220 |
Intraoral - periapical first radiographic image |
1,820 |
1,723 |
$23K |
| D7140 |
Extraction, erupted tooth or exposed root |
139 |
38 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
160 |
155 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
570 |
328 |
$5K |
| D9110 |
|
61 |
58 |
$2K |
| D9930 |
|
28 |
24 |
$798.00 |
| D9219 |
|
1,797 |
1,688 |
$0.00 |
| D1999 |
|
2,395 |
2,083 |
$0.00 |