| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
4,020 |
1,535 |
$1.03M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,611 |
1,843 |
$400K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,276 |
649 |
$209K |
| D9222 |
|
1,866 |
1,843 |
$205K |
| D9310 |
|
2,273 |
2,268 |
$152K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,045 |
1,042 |
$69K |
| D7230 |
|
250 |
172 |
$61K |
| D0330 |
Panoramic radiographic image |
1,285 |
1,276 |
$50K |
| D7140 |
Extraction, erupted tooth or exposed root |
29 |
14 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$593.73 |
| D9610 |
|
821 |
817 |
$0.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
25 |
25 |
$0.00 |