| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7230 |
|
2,175 |
975 |
$365K |
| D7240 |
Removal of impacted tooth - completely bony |
1,331 |
535 |
$257K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,253 |
1,189 |
$206K |
| D9243 |
|
1,709 |
1,689 |
$195K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,439 |
864 |
$155K |
| D0140 |
Limited oral evaluation - problem focused |
3,145 |
3,101 |
$114K |
| D9239 |
|
1,545 |
1,532 |
$114K |
| D9612 |
|
1,785 |
1,771 |
$104K |
| D0330 |
Panoramic radiographic image |
1,231 |
1,210 |
$26K |
| D7220 |
|
145 |
99 |
$17K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
288 |
282 |
$12K |
| D7250 |
|
23 |
13 |
$3K |