| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
3,756 |
1,912 |
$588K |
| D7230 |
|
3,082 |
1,685 |
$360K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
5,201 |
1,626 |
$252K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,983 |
3,173 |
$76K |
| D0330 |
Panoramic radiographic image |
281 |
281 |
$22K |
| D0220 |
Intraoral - periapical first radiographic image |
3,225 |
3,210 |
$16K |
| D0140 |
Limited oral evaluation - problem focused |
364 |
364 |
$6K |
| D7140 |
Extraction, erupted tooth or exposed root |
48 |
12 |
$1K |