| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
4,292 |
1,326 |
$925K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,144 |
1,352 |
$183K |
| D0330 |
Panoramic radiographic image |
2,245 |
2,222 |
$105K |
| D9222 |
|
1,323 |
1,316 |
$75K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,541 |
2,515 |
$69K |
| D7140 |
Extraction, erupted tooth or exposed root |
881 |
354 |
$56K |
| D7230 |
|
111 |
67 |
$27K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
660 |
653 |
$21K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
54 |
38 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
15 |
15 |
$278.46 |
| D9612 |
|
157 |
155 |
$0.00 |