| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
6,533 |
2,632 |
$294K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
4,964 |
3,901 |
$216K |
| D7240 |
Removal of impacted tooth - completely bony |
1,275 |
662 |
$163K |
| D9222 |
|
3,733 |
3,698 |
$80K |
| D0140 |
Limited oral evaluation - problem focused |
2,872 |
2,863 |
$57K |
| D7450 |
|
478 |
467 |
$54K |
| D7250 |
|
771 |
388 |
$36K |
| D0330 |
Panoramic radiographic image |
1,544 |
1,543 |
$25K |
| D7230 |
|
158 |
115 |
$19K |
| D7311 |
|
405 |
216 |
$18K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,248 |
1,247 |
$16K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,707 |
735 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
915 |
911 |
$2K |
| D9310 |
|
80 |
80 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
651 |
507 |
$1K |
| D0240 |
|
12 |
12 |
$100.00 |