| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
6,987 |
2,224 |
$2.14M |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
11,223 |
3,182 |
$1.72M |
| D9243 |
|
7,812 |
3,111 |
$439K |
| D0140 |
Limited oral evaluation - problem focused |
7,306 |
6,836 |
$280K |
| D9239 |
|
3,447 |
3,099 |
$241K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,549 |
634 |
$202K |
| D7450 |
|
665 |
328 |
$140K |
| D0330 |
Panoramic radiographic image |
2,516 |
2,340 |
$120K |
| D7250 |
|
441 |
153 |
$79K |
| D0220 |
Intraoral - periapical first radiographic image |
1,915 |
1,666 |
$21K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,502 |
892 |
$19K |
| D7230 |
|
65 |
42 |
$18K |
| D0120 |
Periodic oral evaluation - established patient |
15 |
15 |
$282.23 |
| D9610 |
|
2,456 |
2,229 |
$0.00 |
| D0472 |
|
54 |
39 |
$0.00 |