| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
5,370 |
1,316 |
$557K |
| D7240 |
Removal of impacted tooth - completely bony |
1,679 |
584 |
$294K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,441 |
1,373 |
$113K |
| D9222 |
|
1,569 |
1,520 |
$105K |
| D7230 |
|
524 |
298 |
$80K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,027 |
1,971 |
$76K |
| D9610 |
|
1,238 |
1,202 |
$41K |
| D0330 |
Panoramic radiographic image |
1,350 |
1,312 |
$22K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
205 |
197 |
$8K |
| D7220 |
|
44 |
30 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
42 |
40 |
$1K |
| D1999 |
|
72 |
70 |
$0.00 |