| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,635 |
861 |
$1.07M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
903 |
723 |
$244K |
| D9222 |
|
750 |
722 |
$205K |
| D0140 |
Limited oral evaluation - problem focused |
1,692 |
1,616 |
$173K |
| D9612 |
|
754 |
724 |
$104K |
| D7230 |
|
244 |
136 |
$103K |
| D0367 |
|
443 |
417 |
$93K |
| D7240 |
Removal of impacted tooth - completely bony |
76 |
40 |
$42K |
| D7140 |
Extraction, erupted tooth or exposed root |
138 |
37 |
$28K |
| D0330 |
Panoramic radiographic image |
152 |
142 |
$17K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
14 |
14 |
$1K |