| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,908 |
672 |
$485K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,258 |
586 |
$333K |
| D9310 |
|
1,413 |
1,393 |
$183K |
| D9222 |
|
602 |
586 |
$119K |
| D9612 |
|
591 |
583 |
$83K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
570 |
567 |
$45K |
| D7140 |
Extraction, erupted tooth or exposed root |
287 |
53 |
$45K |
| D0330 |
Panoramic radiographic image |
299 |
297 |
$19K |
| D0220 |
Intraoral - periapical first radiographic image |
19 |
16 |
$425.00 |