| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
10,776 |
6,204 |
$1.48M |
| D7240 |
Removal of impacted tooth - completely bony |
2,353 |
996 |
$651K |
| D7230 |
|
2,745 |
1,590 |
$640K |
| D0140 |
Limited oral evaluation - problem focused |
10,724 |
10,708 |
$380K |
| D7140 |
Extraction, erupted tooth or exposed root |
3,631 |
1,764 |
$316K |
| D0330 |
Panoramic radiographic image |
6,154 |
6,152 |
$300K |
| D0367 |
|
705 |
705 |
$97K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,081 |
1,074 |
$35K |
| D9239 |
|
29 |
29 |
$2K |
| D9243 |
|
28 |
28 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
54 |
54 |
$692.82 |
| D0230 |
Intraoral - periapical each additional radiographic image |
18 |
16 |
$176.63 |