| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
7,008 |
2,277 |
$747K |
| D7240 |
Removal of impacted tooth - completely bony |
2,800 |
1,186 |
$519K |
| D9243 |
|
4,153 |
2,873 |
$317K |
| D7230 |
|
1,574 |
864 |
$250K |
| D9239 |
|
3,051 |
2,890 |
$211K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,871 |
3,674 |
$157K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
2,771 |
2,636 |
$118K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,802 |
528 |
$111K |
| D0330 |
Panoramic radiographic image |
132 |
127 |
$3K |
| D0170 |
|
50 |
44 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
81 |
40 |
$928.12 |
| D0220 |
Intraoral - periapical first radiographic image |
61 |
55 |
$801.40 |