| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
5,455 |
1,242 |
$320K |
| D7240 |
Removal of impacted tooth - completely bony |
305 |
170 |
$94K |
| D0140 |
Limited oral evaluation - problem focused |
1,582 |
1,570 |
$76K |
| D7230 |
|
211 |
146 |
$42K |
| D0330 |
Panoramic radiographic image |
290 |
286 |
$10K |
| D7310 |
|
270 |
95 |
$8K |
| D0220 |
Intraoral - periapical first radiographic image |
1,052 |
1,034 |
$7K |
| 70320 |
|
195 |
195 |
$7K |
| D0230 |
Intraoral - periapical each additional radiographic image |
302 |
291 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
145 |
145 |
$3K |