| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
3,471 |
1,174 |
$924K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
1,914 |
506 |
$280K |
| 99205 |
Prolong outpt/office vis |
3,334 |
2,833 |
$254K |
| 99215 |
Prolong outpt/office vis |
3,591 |
2,432 |
$175K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,471 |
1,354 |
$132K |
| D0330 |
Panoramic radiographic image |
2,554 |
2,422 |
$127K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,576 |
2,453 |
$78K |
| D9222 |
|
1,456 |
1,367 |
$78K |
| 40801 |
|
441 |
341 |
$57K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
498 |
240 |
$51K |
| D7230 |
|
286 |
177 |
$46K |
| 70355 |
|
3,927 |
3,257 |
$42K |
| D7220 |
|
83 |
55 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60 |
54 |
$2K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
68 |
45 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
24 |
12 |
$1K |
| D0603 |
|
2,540 |
2,433 |
$0.00 |