| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,630 |
1,294 |
$355K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,749 |
519 |
$119K |
| D0330 |
Panoramic radiographic image |
1,722 |
1,643 |
$90K |
| D0140 |
Limited oral evaluation - problem focused |
1,910 |
1,816 |
$73K |
| D7220 |
|
219 |
121 |
$30K |
| D9110 |
|
378 |
355 |
$14K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
63 |
62 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
83 |
69 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
17 |
15 |
$298.00 |