| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,109 |
431 |
$123K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
692 |
645 |
$102K |
| D7140 |
Extraction, erupted tooth or exposed root |
628 |
258 |
$85K |
| D0330 |
Panoramic radiographic image |
1,418 |
1,403 |
$65K |
| D0140 |
Limited oral evaluation - problem focused |
1,255 |
1,246 |
$59K |
| D9222 |
|
659 |
645 |
$52K |
| D9310 |
|
843 |
825 |
$47K |
| D7230 |
|
17 |
12 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
175 |
175 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
95 |
91 |
$1K |