| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
25,043 |
4,274 |
$2.08M |
| D9243 |
|
22,512 |
6,033 |
$933K |
| D7230 |
|
5,352 |
2,071 |
$929K |
| D7240 |
Removal of impacted tooth - completely bony |
3,976 |
1,304 |
$650K |
| D9239 |
|
6,312 |
6,056 |
$580K |
| D0367 |
|
4,795 |
4,610 |
$391K |
| D7310 |
|
2,201 |
697 |
$294K |
| D9612 |
|
5,594 |
5,370 |
$259K |
| D0140 |
Limited oral evaluation - problem focused |
8,143 |
7,673 |
$242K |
| D7140 |
Extraction, erupted tooth or exposed root |
4,278 |
716 |
$236K |
| D0330 |
Panoramic radiographic image |
4,294 |
4,075 |
$188K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
1,370 |
444 |
$116K |
| D9610 |
|
5,538 |
5,251 |
$113K |
| D9222 |
|
461 |
442 |
$85K |
| D7250 |
|
469 |
140 |
$57K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
426 |
403 |
$11K |
| D0350 |
|
120 |
115 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
72 |
71 |
$630.14 |
| D0230 |
Intraoral - periapical each additional radiographic image |
20 |
14 |
$142.45 |