| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
7,021 |
3,090 |
$858K |
| D7240 |
Removal of impacted tooth - completely bony |
2,835 |
1,089 |
$721K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,677 |
2,601 |
$720K |
| D9222 |
|
2,522 |
2,497 |
$247K |
| D0330 |
Panoramic radiographic image |
2,722 |
2,668 |
$166K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,645 |
2,602 |
$147K |
| D9310 |
|
1,907 |
1,880 |
$134K |
| D7230 |
|
539 |
380 |
$105K |
| D7250 |
|
308 |
205 |
$59K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,334 |
1,319 |
$43K |
| D0367 |
|
154 |
153 |
$27K |
| D7140 |
Extraction, erupted tooth or exposed root |
181 |
69 |
$13K |
| D0431 |
|
1,253 |
1,244 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
1,248 |
1,239 |
$0.00 |