| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
4,362 |
1,132 |
$1.18M |
| D0140 |
Limited oral evaluation - problem focused |
1,682 |
1,601 |
$116K |
| D0330 |
Panoramic radiographic image |
1,916 |
1,840 |
$97K |
| D9222 |
|
159 |
149 |
$31K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
308 |
301 |
$26K |
| D7250 |
|
37 |
12 |
$13K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
193 |
184 |
$11K |
| D7140 |
Extraction, erupted tooth or exposed root |
50 |
12 |
$8K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
42 |
27 |
$8K |
| D9310 |
|
137 |
135 |
$7K |
| D9239 |
|
26 |
24 |
$5K |