| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
5,500 |
2,043 |
$650K |
| D7240 |
Removal of impacted tooth - completely bony |
2,796 |
1,277 |
$645K |
| D7230 |
|
2,668 |
1,303 |
$503K |
| D9220 |
|
1,468 |
1,458 |
$304K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
4,865 |
4,828 |
$301K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,674 |
1,662 |
$200K |
| D9222 |
|
1,659 |
1,653 |
$199K |
| D9610 |
|
3,171 |
3,118 |
$130K |
| D0330 |
Panoramic radiographic image |
3,468 |
3,443 |
$101K |
| D0220 |
Intraoral - periapical first radiographic image |
1,103 |
1,101 |
$13K |
| D7140 |
Extraction, erupted tooth or exposed root |
177 |
51 |
$10K |
| D7220 |
|
63 |
40 |
$9K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,247 |
864 |
$8K |
| D0240 |
|
105 |
103 |
$1K |
| D9999 |
Unspecified adjunctive procedure, by report |
22 |
22 |
$0.00 |