| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
4,554 |
3,183 |
$1.33M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
4,704 |
3,056 |
$462K |
| D9310 |
|
6,871 |
6,871 |
$417K |
| D7230 |
|
1,670 |
1,342 |
$287K |
| D0330 |
Panoramic radiographic image |
6,605 |
6,605 |
$243K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,702 |
2,699 |
$225K |
| D9222 |
|
2,701 |
2,701 |
$131K |
| D0364 |
|
107 |
107 |
$35K |
| D0220 |
Intraoral - periapical first radiographic image |
2,033 |
2,026 |
$22K |
| D0367 |
|
69 |
69 |
$20K |
| D9243 |
|
168 |
168 |
$10K |
| D9239 |
|
166 |
166 |
$8K |
| D0140 |
Limited oral evaluation - problem focused |
672 |
672 |
$8K |
| D7140 |
Extraction, erupted tooth or exposed root |
51 |
41 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
227 |
225 |
$1K |
| D0210 |
Intraoral - complete series of radiographic images |
126 |
124 |
$315.25 |
| D1999 |
|
86 |
81 |
$0.00 |