| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
3,596 |
1,594 |
$606K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
6,056 |
1,672 |
$487K |
| D0330 |
Panoramic radiographic image |
3,462 |
3,216 |
$122K |
| D7310 |
|
669 |
356 |
$115K |
| D0140 |
Limited oral evaluation - problem focused |
2,592 |
2,428 |
$71K |
| 21025 |
|
103 |
100 |
$45K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,638 |
1,510 |
$41K |
| D7471 |
|
162 |
148 |
$27K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,095 |
1,034 |
$26K |
| D7285 |
|
27 |
25 |
$11K |
| D7140 |
Extraction, erupted tooth or exposed root |
244 |
66 |
$7K |
| D1999 |
|
303 |
219 |
$4K |
| D9930 |
|
55 |
47 |
$2K |
| D9248 |
|
16 |
13 |
$770.00 |