| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
2,808 |
840 |
$760K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
972 |
945 |
$208K |
| D9222 |
|
970 |
943 |
$68K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
566 |
256 |
$58K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
911 |
899 |
$47K |
| D7230 |
|
62 |
37 |
$13K |
| D9310 |
|
272 |
260 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
119 |
117 |
$5K |
| D0330 |
Panoramic radiographic image |
71 |
65 |
$3K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
12 |
12 |
$216.00 |