| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
9,284 |
4,944 |
$1.95M |
| D7240 |
Removal of impacted tooth - completely bony |
3,823 |
1,829 |
$1.16M |
| D7230 |
|
3,161 |
1,975 |
$723K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,094 |
2,279 |
$586K |
| D0330 |
Panoramic radiographic image |
6,492 |
6,197 |
$407K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,285 |
1,231 |
$356K |
| D9222 |
|
2,692 |
2,253 |
$337K |
| D9310 |
|
5,339 |
5,200 |
$279K |
| D0140 |
Limited oral evaluation - problem focused |
3,717 |
3,516 |
$169K |
| D0210 |
Intraoral - complete series of radiographic images |
24 |
24 |
$705.50 |
| D1999 |
|
387 |
329 |
$0.00 |