| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
571 |
325 |
$80K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
471 |
215 |
$69K |
| D9222 |
|
328 |
325 |
$45K |
| D7140 |
Extraction, erupted tooth or exposed root |
352 |
74 |
$29K |
| D0330 |
Panoramic radiographic image |
342 |
341 |
$25K |
| D7240 |
Removal of impacted tooth - completely bony |
76 |
27 |
$22K |
| D9610 |
|
325 |
322 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
199 |
199 |
$10K |
| D0140 |
Limited oral evaluation - problem focused |
99 |
98 |
$4K |