| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
143 |
133 |
$84K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,249 |
268 |
$71K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
354 |
314 |
$55K |
| D9222 |
|
350 |
317 |
$37K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
162 |
160 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
78 |
78 |
$4K |
| D7230 |
|
12 |
12 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
155 |
154 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
66 |
12 |
$3K |
| D0330 |
Panoramic radiographic image |
57 |
57 |
$2K |
| 99201 |
|
14 |
14 |
$345.52 |
| D0120 |
Periodic oral evaluation - established patient |
13 |
13 |
$180.00 |