| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
6,730 |
3,172 |
$1.27M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
8,902 |
2,768 |
$881K |
| D9222 |
|
1,086 |
1,012 |
$253K |
| D0140 |
Limited oral evaluation - problem focused |
3,568 |
3,336 |
$203K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,448 |
1,408 |
$149K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
445 |
113 |
$55K |
| D7220 |
|
101 |
29 |
$31K |
| D0330 |
Panoramic radiographic image |
395 |
361 |
$19K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
961 |
838 |
$13K |
| D7240 |
Removal of impacted tooth - completely bony |
2,663 |
577 |
$4K |
| D7230 |
|
386 |
100 |
$0.00 |