| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
5,605 |
1,714 |
$1.31M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
6,510 |
2,327 |
$523K |
| D9222 |
|
2,319 |
2,271 |
$198K |
| D9612 |
|
2,322 |
2,272 |
$108K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
649 |
326 |
$76K |
| D0120 |
Periodic oral evaluation - established patient |
1,945 |
1,916 |
$46K |
| D0330 |
Panoramic radiographic image |
960 |
949 |
$14K |
| D0367 |
|
685 |
672 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
160 |
158 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
156 |
153 |
$4K |
| D0160 |
|
138 |
137 |
$83.86 |