| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,877 |
1,607 |
$231K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,245 |
1,200 |
$143K |
| D0367 |
|
285 |
285 |
$72K |
| D0330 |
Panoramic radiographic image |
2,261 |
2,251 |
$69K |
| D9222 |
|
901 |
890 |
$63K |
| D7140 |
Extraction, erupted tooth or exposed root |
852 |
240 |
$44K |
| D0160 |
|
1,592 |
1,587 |
$39K |
| D9310 |
|
575 |
575 |
$26K |
| D0365 |
|
99 |
99 |
$26K |
| D0366 |
|
82 |
82 |
$21K |
| D7261 |
|
78 |
74 |
$13K |
| D7240 |
Removal of impacted tooth - completely bony |
51 |
27 |
$12K |
| D0140 |
Limited oral evaluation - problem focused |
435 |
433 |
$6K |
| D7310 |
|
147 |
74 |
$3K |
| D9610 |
|
108 |
106 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
51 |
49 |
$481.01 |
| D0230 |
Intraoral - periapical each additional radiographic image |
19 |
16 |
$149.35 |
| D1999 |
|
172 |
168 |
$0.00 |