| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,350 |
732 |
$355K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,050 |
1,897 |
$330K |
| D9222 |
|
2,266 |
2,227 |
$325K |
| D7240 |
Removal of impacted tooth - completely bony |
1,782 |
586 |
$319K |
| D7250 |
|
1,544 |
297 |
$197K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,049 |
366 |
$176K |
| D0330 |
Panoramic radiographic image |
1,547 |
1,490 |
$63K |
| D0140 |
Limited oral evaluation - problem focused |
2,771 |
2,688 |
$53K |
| D7310 |
|
111 |
84 |
$14K |
| D7241 |
|
57 |
26 |
$12K |
| D9110 |
|
87 |
56 |
$3K |
| D7230 |
|
17 |
12 |
$3K |
| D7963 |
|
13 |
12 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12 |
12 |
$660.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
28 |
28 |
$532.00 |