| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
6,663 |
3,079 |
$595K |
| D0330 |
Panoramic radiographic image |
3,828 |
3,796 |
$152K |
| D7240 |
Removal of impacted tooth - completely bony |
107 |
84 |
$54K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,594 |
1,586 |
$49K |
| D0160 |
|
1,464 |
1,462 |
$40K |
| D9999 |
Unspecified adjunctive procedure, by report |
196 |
184 |
$28K |
| D9310 |
|
259 |
259 |
$27K |
| D7230 |
|
46 |
42 |
$11K |
| D0120 |
Periodic oral evaluation - established patient |
300 |
300 |
$9K |
| D7140 |
Extraction, erupted tooth or exposed root |
76 |
42 |
$6K |
| D7250 |
|
72 |
29 |
$5K |
| D0367 |
|
12 |
12 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
101 |
100 |
$119.45 |
| D0220 |
Intraoral - periapical first radiographic image |
12 |
12 |
$13.30 |