| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,752 |
2,298 |
$283K |
| D0330 |
Panoramic radiographic image |
4,837 |
4,830 |
$137K |
| D9243 |
|
1,323 |
1,297 |
$120K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,712 |
3,704 |
$83K |
| D9239 |
|
1,090 |
1,084 |
$76K |
| D9310 |
|
1,151 |
1,150 |
$45K |
| D7230 |
|
107 |
79 |
$15K |
| D7140 |
Extraction, erupted tooth or exposed root |
134 |
64 |
$8K |
| D7240 |
Removal of impacted tooth - completely bony |
31 |
14 |
$7K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
32 |
32 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
28 |
28 |
$354.90 |