| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
8,683 |
3,114 |
$1.94M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,554 |
2,268 |
$716K |
| D7230 |
|
1,915 |
1,057 |
$351K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,617 |
1,420 |
$300K |
| D9220 |
|
1,403 |
1,394 |
$300K |
| D9221 |
|
1,894 |
1,396 |
$287K |
| D9222 |
|
2,303 |
2,267 |
$274K |
| 70486 |
|
1,041 |
1,038 |
$112K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
579 |
579 |
$95K |
| 99205 |
Prolong outpt/office vis |
454 |
454 |
$88K |
| D9610 |
|
3,257 |
3,229 |
$68K |
| D0330 |
Panoramic radiographic image |
1,769 |
1,751 |
$51K |
| D7140 |
Extraction, erupted tooth or exposed root |
283 |
125 |
$16K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
301 |
300 |
$11K |