| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
6,782 |
2,448 |
$1.20M |
| D7240 |
Removal of impacted tooth - completely bony |
3,641 |
1,319 |
$1.14M |
| D9222 |
|
3,345 |
3,296 |
$490K |
| D7140 |
Extraction, erupted tooth or exposed root |
4,744 |
721 |
$470K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,412 |
3,271 |
$437K |
| D7230 |
|
225 |
143 |
$64K |
| D0140 |
Limited oral evaluation - problem focused |
1,210 |
1,193 |
$57K |
| D7220 |
|
39 |
27 |
$10K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
52 |
52 |
$2K |
| J0690 |
Injection, cefazolin sodium, 500 mg |
325 |
278 |
$2K |
| S0077 |
Injection, clindamycin phosphate, 300 mg |
391 |
371 |
$226.05 |