| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
4,865 |
2,078 |
$1.26M |
| D7240 |
Removal of impacted tooth - completely bony |
1,696 |
800 |
$601K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
3,107 |
1,985 |
$571K |
| D7230 |
|
1,488 |
884 |
$390K |
| D9222 |
|
2,358 |
1,947 |
$238K |
| D0330 |
Panoramic radiographic image |
3,023 |
2,813 |
$161K |
| D9310 |
|
1,768 |
1,666 |
$93K |
| D0140 |
Limited oral evaluation - problem focused |
2,061 |
1,921 |
$91K |
| D7140 |
Extraction, erupted tooth or exposed root |
364 |
154 |
$82K |
| D0210 |
Intraoral - complete series of radiographic images |
49 |
49 |
$1K |
| D1999 |
|
386 |
320 |
$0.00 |