| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
3,205 |
1,219 |
$179K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,783 |
1,722 |
$44K |
| D7230 |
|
260 |
177 |
$35K |
| D0330 |
Panoramic radiographic image |
354 |
334 |
$15K |
| D7220 |
|
96 |
69 |
$9K |
| D7310 |
|
47 |
24 |
$5K |
| D7240 |
Removal of impacted tooth - completely bony |
26 |
12 |
$3K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
50 |
23 |
$3K |
| D9222 |
|
12 |
12 |
$1K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
65 |
62 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
69 |
64 |
$323.00 |