| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
1,181 |
384 |
$242K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
961 |
628 |
$106K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,140 |
401 |
$96K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,738 |
1,699 |
$88K |
| D0330 |
Panoramic radiographic image |
1,806 |
1,754 |
$72K |
| D9222 |
|
498 |
485 |
$40K |
| D9610 |
|
554 |
537 |
$22K |
| D7140 |
Extraction, erupted tooth or exposed root |
43 |
12 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
29 |
26 |
$995.21 |