| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,424 |
1,405 |
$437K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,687 |
954 |
$208K |
| D0330 |
Panoramic radiographic image |
2,275 |
2,270 |
$173K |
| D0140 |
Limited oral evaluation - problem focused |
2,116 |
2,109 |
$110K |
| D7240 |
Removal of impacted tooth - completely bony |
308 |
133 |
$108K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
647 |
642 |
$84K |
| D9222 |
|
641 |
637 |
$63K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
391 |
387 |
$9K |
| D9610 |
|
86 |
84 |
$1K |