| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
2,296 |
639 |
$171K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
167 |
153 |
$50K |
| D7240 |
Removal of impacted tooth - completely bony |
193 |
66 |
$38K |
| D9222 |
|
160 |
153 |
$20K |
| D0330 |
Panoramic radiographic image |
484 |
471 |
$16K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
206 |
117 |
$13K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
601 |
592 |
$12K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
71 |
69 |
$3K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
70 |
68 |
$1K |
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$280.00 |