| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
4,267 |
1,879 |
$958K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,500 |
2,284 |
$692K |
| D7230 |
|
2,136 |
1,109 |
$401K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,654 |
5,626 |
$343K |
| D9222 |
|
2,274 |
2,270 |
$274K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,581 |
821 |
$184K |
| D0330 |
Panoramic radiographic image |
2,045 |
2,019 |
$65K |
| D9220 |
|
234 |
234 |
$51K |
| D9221 |
|
315 |
238 |
$37K |
| D0220 |
Intraoral - periapical first radiographic image |
1,985 |
1,966 |
$23K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
475 |
475 |
$18K |
| 70486 |
|
55 |
55 |
$7K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,588 |
798 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
55 |
55 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
29 |
12 |
$2K |
| 99205 |
Prolong outpt/office vis |
13 |
13 |
$1K |
| 76376 |
|
51 |
51 |
$1K |
| D9430 |
|
17 |
17 |
$544.00 |