| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,923 |
2,095 |
$197K |
| D7240 |
Removal of impacted tooth - completely bony |
575 |
403 |
$150K |
| D9999 |
Unspecified adjunctive procedure, by report |
731 |
664 |
$106K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,675 |
2,652 |
$56K |
| D0330 |
Panoramic radiographic image |
2,213 |
2,212 |
$47K |
| D7230 |
|
253 |
207 |
$38K |
| D9310 |
|
510 |
510 |
$25K |
| D0140 |
Limited oral evaluation - problem focused |
672 |
667 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
33 |
28 |
$537.90 |
| D0220 |
Intraoral - periapical first radiographic image |
99 |
96 |
$414.99 |