| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
23,028 |
8,745 |
$3.14M |
| D7240 |
Removal of impacted tooth - completely bony |
6,860 |
2,523 |
$2.14M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
25,920 |
11,385 |
$2.08M |
| D9222 |
|
11,941 |
11,467 |
$946K |
| D7140 |
Extraction, erupted tooth or exposed root |
10,960 |
3,717 |
$775K |
| D0330 |
Panoramic radiographic image |
10,123 |
9,733 |
$664K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
12,843 |
12,434 |
$524K |
| D7230 |
|
833 |
523 |
$196K |
| D0120 |
Periodic oral evaluation - established patient |
3,442 |
3,332 |
$70K |
| D0140 |
Limited oral evaluation - problem focused |
133 |
132 |
$5K |
| D7310 |
|
28 |
12 |
$4K |
| D9110 |
|
39 |
38 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
24 |
24 |
$322.00 |
| D1999 |
|
2,168 |
1,910 |
$0.00 |
| D9610 |
|
50 |
48 |
$0.00 |