| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
6,500 |
2,723 |
$1.25M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
5,634 |
1,232 |
$1.24M |
| D9222 |
|
3,218 |
2,784 |
$652K |
| D9310 |
|
3,890 |
3,542 |
$448K |
| D7230 |
|
1,324 |
719 |
$446K |
| D7220 |
|
1,073 |
493 |
$289K |
| D9612 |
|
3,203 |
2,792 |
$176K |
| D0330 |
Panoramic radiographic image |
1,631 |
1,357 |
$152K |
| D9630 |
|
2,960 |
2,559 |
$106K |
| D7140 |
Extraction, erupted tooth or exposed root |
213 |
39 |
$32K |
| D7240 |
Removal of impacted tooth - completely bony |
88 |
41 |
$31K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
127 |
103 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
41 |
41 |
$3K |