| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
745 |
735 |
$71K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
832 |
723 |
$67K |
| D7140 |
Extraction, erupted tooth or exposed root |
791 |
392 |
$43K |
| D9222 |
|
355 |
350 |
$30K |
| D0330 |
Panoramic radiographic image |
816 |
814 |
$27K |
| D0160 |
|
550 |
548 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
343 |
342 |
$9K |
| D0220 |
Intraoral - periapical first radiographic image |
45 |
45 |
$459.00 |
| D0140 |
Limited oral evaluation - problem focused |
14 |
14 |
$208.00 |