| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
1,524 |
505 |
$285K |
| D9239 |
|
2,089 |
1,993 |
$149K |
| D7230 |
|
838 |
331 |
$135K |
| D9612 |
|
1,955 |
1,874 |
$113K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
2,275 |
2,166 |
$99K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,525 |
452 |
$93K |
| D9243 |
|
911 |
857 |
$75K |
| D0140 |
Limited oral evaluation - problem focused |
1,846 |
1,748 |
$66K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
636 |
245 |
$65K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
788 |
741 |
$31K |
| D0220 |
Intraoral - periapical first radiographic image |
139 |
134 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
67 |
64 |
$805.12 |