| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
3,562 |
1,105 |
$1.16M |
| D7140 |
Extraction, erupted tooth or exposed root |
6,932 |
2,324 |
$520K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,521 |
1,945 |
$336K |
| D9222 |
|
2,187 |
2,106 |
$201K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,246 |
775 |
$174K |
| D0330 |
Panoramic radiographic image |
2,048 |
1,993 |
$154K |
| D0140 |
Limited oral evaluation - problem focused |
2,793 |
2,723 |
$113K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
431 |
424 |
$22K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,076 |
1,041 |
$16K |