| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
8,098 |
3,006 |
$923K |
| D9243 |
|
4,066 |
3,980 |
$854K |
| D7240 |
Removal of impacted tooth - completely bony |
3,805 |
1,444 |
$774K |
| D7250 |
|
2,431 |
898 |
$301K |
| D9612 |
|
4,729 |
4,619 |
$287K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
4,799 |
4,681 |
$216K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,835 |
4,731 |
$214K |
| D7220 |
|
1,522 |
955 |
$199K |
| D7230 |
|
1,014 |
685 |
$179K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
666 |
640 |
$175K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,511 |
734 |
$166K |
| D0330 |
Panoramic radiographic image |
1,976 |
1,921 |
$81K |
| D7241 |
|
60 |
39 |
$15K |
| D7311 |
|
58 |
41 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
143 |
142 |
$5K |
| D7310 |
|
26 |
13 |
$3K |
| D9110 |
|
41 |
40 |
$2K |
| D0274 |
Bitewings - four radiographic images |
38 |
38 |
$387.53 |