| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
6,407 |
1,300 |
$864K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
4,487 |
2,416 |
$722K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,929 |
789 |
$344K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,180 |
1,882 |
$136K |
| D9222 |
|
1,783 |
1,344 |
$114K |
| D7230 |
|
1,270 |
273 |
$74K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
1,452 |
1,203 |
$41K |
| D0140 |
Limited oral evaluation - problem focused |
725 |
675 |
$32K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
336 |
95 |
$30K |
| 96375 |
Therapeutic injection; each additional sequential IV push |
1,388 |
1,150 |
$16K |
| 70110 |
|
850 |
713 |
$15K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
230 |
225 |
$11K |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
81 |
76 |
$8K |
| D0330 |
Panoramic radiographic image |
71 |
68 |
$3K |
| 70355 |
|
79 |
65 |
$203.69 |