| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9310 |
|
4,100 |
4,099 |
$495K |
| D0330 |
Panoramic radiographic image |
3,696 |
3,696 |
$369K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
326 |
325 |
$173K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
528 |
528 |
$43K |
| D9420 |
|
110 |
110 |
$32K |
| D0160 |
|
229 |
229 |
$29K |
| D0220 |
Intraoral - periapical first radiographic image |
694 |
693 |
$17K |
| D7240 |
Removal of impacted tooth - completely bony |
12 |
12 |
$14K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
26 |
26 |
$14K |
| D7140 |
Extraction, erupted tooth or exposed root |
12 |
12 |
$6K |
| D9222 |
|
13 |
13 |
$2K |
| D0140 |
Limited oral evaluation - problem focused |
26 |
26 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
31 |
31 |
$2K |