| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
1,170 |
388 |
$258K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,751 |
1,482 |
$221K |
| D7241 |
|
642 |
207 |
$165K |
| D9222 |
|
1,669 |
1,487 |
$151K |
| D0330 |
Panoramic radiographic image |
2,234 |
2,095 |
$98K |
| D9310 |
|
2,145 |
2,020 |
$97K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
819 |
321 |
$85K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,044 |
960 |
$31K |
| D7230 |
|
137 |
73 |
$26K |
| D7140 |
Extraction, erupted tooth or exposed root |
275 |
69 |
$18K |
| D7220 |
|
99 |
54 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$490.90 |
| D9610 |
|
24 |
22 |
$0.00 |
| D1999 |
|
25 |
22 |
$0.00 |
| D9215 |
|
34 |
30 |
$0.00 |