| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,231 |
288 |
$206K |
| D7240 |
Removal of impacted tooth - completely bony |
449 |
162 |
$109K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
836 |
835 |
$78K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,333 |
217 |
$43K |
| D0330 |
Panoramic radiographic image |
479 |
479 |
$19K |
| D9222 |
|
254 |
254 |
$12K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
988 |
375 |
$8K |
| 41874 |
|
37 |
13 |
$6K |
| D0140 |
Limited oral evaluation - problem focused |
677 |
674 |
$4K |
| 96374 |
Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance |
55 |
55 |
$2K |
| 99153 |
Mod sedat endo service >5yrs |
129 |
114 |
$1K |