| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
4,097 |
1,162 |
$896K |
| D9243 |
|
4,410 |
1,598 |
$290K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,125 |
507 |
$145K |
| D9239 |
|
1,661 |
1,561 |
$108K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,862 |
3,705 |
$105K |
| D7140 |
Extraction, erupted tooth or exposed root |
736 |
125 |
$48K |
| D7250 |
|
268 |
80 |
$34K |
| D0330 |
Panoramic radiographic image |
453 |
439 |
$17K |
| D7220 |
|
68 |
29 |
$10K |
| D7230 |
|
23 |
12 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
319 |
124 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
212 |
205 |
$3K |
| D1999 |
|
26 |
26 |
$0.00 |