| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
5,829 |
3,433 |
$1.38M |
| D7230 |
|
3,484 |
2,078 |
$915K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
4,440 |
3,201 |
$910K |
| D7240 |
Removal of impacted tooth - completely bony |
2,005 |
1,181 |
$748K |
| D9222 |
|
3,821 |
3,189 |
$440K |
| D0330 |
Panoramic radiographic image |
5,688 |
5,375 |
$306K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,613 |
1,196 |
$285K |
| D9310 |
|
4,742 |
4,485 |
$250K |
| D0140 |
Limited oral evaluation - problem focused |
3,823 |
3,645 |
$168K |
| D7220 |
|
31 |
24 |
$7K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
88 |
74 |
$4K |
| D1999 |
|
617 |
479 |
$0.00 |