| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,471 |
534 |
$96K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
352 |
122 |
$34K |
| D0140 |
Limited oral evaluation - problem focused |
709 |
660 |
$23K |
| D9222 |
|
140 |
138 |
$11K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
225 |
218 |
$10K |
| D7230 |
|
60 |
24 |
$9K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
205 |
197 |
$9K |
| D9610 |
|
207 |
197 |
$7K |
| D0330 |
Panoramic radiographic image |
242 |
224 |
$6K |
| D7240 |
Removal of impacted tooth - completely bony |
31 |
13 |
$6K |