| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
14,797 |
6,078 |
$1.00M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
21,158 |
10,912 |
$785K |
| D0140 |
Limited oral evaluation - problem focused |
53,264 |
51,264 |
$617K |
| D0330 |
Panoramic radiographic image |
25,152 |
23,943 |
$402K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
2,266 |
2,123 |
$313K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
8,163 |
6,264 |
$291K |
| D9222 |
|
5,981 |
5,659 |
$152K |
| D7230 |
|
1,265 |
804 |
$90K |
| D0220 |
Intraoral - periapical first radiographic image |
13,640 |
13,050 |
$42K |
| D9612 |
|
2,117 |
2,026 |
$14K |
| D7250 |
|
162 |
81 |
$6K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
392 |
384 |
$3K |
| D9610 |
|
228 |
216 |
$2K |
| D0270 |
|
886 |
861 |
$2K |
| D2950 |
|
83 |
75 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
143 |
138 |
$296.80 |
| D0364 |
|
544 |
477 |
$198.21 |
| D7921 |
|
138 |
112 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
54 |
24 |
$0.00 |