| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,091 |
1,061 |
$297K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
983 |
826 |
$184K |
| D9222 |
|
831 |
827 |
$112K |
| D7240 |
Removal of impacted tooth - completely bony |
268 |
109 |
$43K |
| D0330 |
Panoramic radiographic image |
888 |
887 |
$38K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,415 |
1,414 |
$32K |
| D7230 |
|
213 |
126 |
$29K |
| D7140 |
Extraction, erupted tooth or exposed root |
109 |
29 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
50 |
50 |
$2K |