| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
57,079 |
11,542 |
$3.59M |
| D7240 |
Removal of impacted tooth - completely bony |
8,239 |
3,563 |
$1.50M |
| D0330 |
Panoramic radiographic image |
17,456 |
16,779 |
$846K |
| D9222 |
|
5,842 |
5,571 |
$737K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
20,301 |
19,477 |
$562K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
7,998 |
4,762 |
$551K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,572 |
1,574 |
$225K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
984 |
919 |
$57K |
| D7310 |
|
236 |
93 |
$33K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
657 |
649 |
$20K |
| D7220 |
|
156 |
84 |
$16K |
| 70355 |
|
1,223 |
1,156 |
$7K |
| D7230 |
|
42 |
26 |
$6K |