| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
5,766 |
1,772 |
$951K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,917 |
2,633 |
$550K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
4,660 |
871 |
$510K |
| D7230 |
|
1,722 |
762 |
$309K |
| D9222 |
|
2,746 |
2,679 |
$279K |
| D9612 |
|
2,720 |
2,667 |
$131K |
| D0330 |
Panoramic radiographic image |
2,603 |
2,556 |
$112K |
| D0140 |
Limited oral evaluation - problem focused |
3,008 |
2,951 |
$77K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
2,772 |
2,721 |
$75K |
| D7280 |
|
359 |
218 |
$45K |
| D7140 |
Extraction, erupted tooth or exposed root |
687 |
230 |
$38K |
| D7283 |
|
116 |
86 |
$20K |
| D7310 |
|
93 |
31 |
$14K |