| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
10,573 |
3,723 |
$2.19M |
| D7230 |
|
2,303 |
876 |
$359K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
9,776 |
9,519 |
$316K |
| D7220 |
|
2,251 |
780 |
$289K |
| D0330 |
Panoramic radiographic image |
4,579 |
4,462 |
$224K |
| D9239 |
|
1,866 |
1,843 |
$217K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,237 |
1,068 |
$210K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,852 |
706 |
$196K |
| D9222 |
|
3,363 |
3,293 |
$179K |
| D9243 |
|
2,068 |
1,625 |
$116K |
| D9610 |
|
5,021 |
4,888 |
$108K |
| 70486 |
|
765 |
745 |
$73K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
603 |
562 |
$28K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
190 |
186 |
$20K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
294 |
292 |
$19K |
| 99215 |
Prolong outpt/office vis |
114 |
114 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
637 |
611 |
$10K |
| D0140 |
Limited oral evaluation - problem focused |
116 |
113 |
$3K |
| D0340 |
|
63 |
63 |
$3K |
| D9612 |
|
45 |
43 |
$824.09 |
| D1999 |
|
431 |
383 |
$0.00 |
| 99072 |
|
58 |
55 |
$0.00 |
| D0601 |
|
1,568 |
1,528 |
$0.00 |
| D0602 |
|
342 |
335 |
$0.00 |
| D0603 |
|
79 |
75 |
$0.00 |