| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
7,267 |
1,852 |
$771K |
| D9243 |
|
1,744 |
1,674 |
$553K |
| D7230 |
|
1,217 |
527 |
$201K |
| D7240 |
Removal of impacted tooth - completely bony |
1,022 |
347 |
$196K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,338 |
3,271 |
$116K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
131 |
130 |
$37K |
| D0330 |
Panoramic radiographic image |
1,427 |
1,260 |
$24K |
| D7220 |
|
72 |
41 |
$9K |
| D0140 |
Limited oral evaluation - problem focused |
147 |
147 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
230 |
227 |
$5K |
| D9222 |
|
60 |
59 |
$4K |
| D7310 |
|
41 |
15 |
$4K |