| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
6,684 |
1,842 |
$1.22M |
| D7230 |
|
6,500 |
1,975 |
$1.07M |
| D9222 |
|
4,144 |
3,786 |
$507K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
4,525 |
3,807 |
$495K |
| D0140 |
Limited oral evaluation - problem focused |
3,686 |
3,437 |
$98K |
| D0330 |
Panoramic radiographic image |
2,234 |
2,032 |
$43K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
295 |
183 |
$29K |
| D7971 |
|
132 |
68 |
$9K |
| D9310 |
|
79 |
77 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
511 |
146 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
184 |
150 |
$2K |
| D9612 |
|
169 |
155 |
$0.00 |