| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,535 |
912 |
$685K |
| D0140 |
Limited oral evaluation - problem focused |
1,908 |
1,795 |
$166K |
| D7250 |
|
462 |
155 |
$148K |
| D9222 |
|
525 |
494 |
$102K |
| D7140 |
Extraction, erupted tooth or exposed root |
332 |
83 |
$52K |
| D0330 |
Panoramic radiographic image |
892 |
869 |
$44K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
345 |
308 |
$15K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
65 |
45 |
$13K |
| D7240 |
Removal of impacted tooth - completely bony |
32 |
17 |
$12K |