| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
3,928 |
1,317 |
$281K |
| D0330 |
Panoramic radiographic image |
995 |
956 |
$67K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
737 |
477 |
$66K |
| D0140 |
Limited oral evaluation - problem focused |
1,252 |
1,219 |
$50K |
| D7240 |
Removal of impacted tooth - completely bony |
119 |
36 |
$41K |
| D9222 |
|
312 |
296 |
$27K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
30 |
29 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$154.00 |