| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
16,078 |
5,245 |
$2.19M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
12,280 |
5,951 |
$1.03M |
| D7240 |
Removal of impacted tooth - completely bony |
3,189 |
1,134 |
$1.03M |
| D7140 |
Extraction, erupted tooth or exposed root |
8,122 |
3,299 |
$606K |
| D0330 |
Panoramic radiographic image |
8,842 |
8,651 |
$593K |
| D9222 |
|
6,935 |
6,670 |
$563K |
| D7230 |
|
1,326 |
712 |
$329K |
| D0140 |
Limited oral evaluation - problem focused |
6,242 |
6,106 |
$239K |
| D7250 |
|
1,143 |
396 |
$147K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,302 |
3,252 |
$119K |
| D7220 |
|
83 |
57 |
$16K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
220 |
213 |
$3K |
| D7311 |
|
27 |
12 |
$2K |
| D0120 |
Periodic oral evaluation - established patient |
30 |
30 |
$642.00 |