| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
1,653 |
558 |
$333K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,660 |
946 |
$225K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,482 |
514 |
$211K |
| D7230 |
|
997 |
450 |
$174K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,379 |
1,201 |
$115K |
| D9222 |
|
1,028 |
952 |
$98K |
| D7220 |
|
342 |
158 |
$51K |
| D0330 |
Panoramic radiographic image |
617 |
548 |
$18K |
| D0140 |
Limited oral evaluation - problem focused |
221 |
198 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
117 |
112 |
$4K |
| D1999 |
|
19 |
18 |
$304.00 |