| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
5,128 |
1,695 |
$1.19M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
10,186 |
4,678 |
$784K |
| D9222 |
|
4,841 |
4,602 |
$385K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,387 |
1,073 |
$265K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,994 |
3,870 |
$104K |
| D7230 |
|
389 |
210 |
$79K |
| D0330 |
Panoramic radiographic image |
4,716 |
4,523 |
$64K |
| D0140 |
Limited oral evaluation - problem focused |
1,361 |
1,347 |
$32K |
| D7140 |
Extraction, erupted tooth or exposed root |
107 |
49 |
$6K |
| D7220 |
|
27 |
13 |
$4K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
127 |
115 |
$326.98 |
| D9219 |
|
15 |
15 |
$0.00 |
| D0391 |
|
12 |
12 |
$0.00 |