| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
921 |
884 |
$198K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,911 |
693 |
$194K |
| D7240 |
Removal of impacted tooth - completely bony |
495 |
186 |
$89K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,025 |
973 |
$41K |
| D7230 |
|
243 |
138 |
$39K |
| D9243 |
|
58 |
57 |
$12K |
| D0120 |
Periodic oral evaluation - established patient |
250 |
232 |
$5K |
| D7140 |
Extraction, erupted tooth or exposed root |
46 |
14 |
$3K |
| D0330 |
Panoramic radiographic image |
30 |
26 |
$703.62 |