| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
7,868 |
2,259 |
$1.20M |
| D7240 |
Removal of impacted tooth - completely bony |
2,435 |
828 |
$669K |
| D9243 |
|
7,052 |
2,351 |
$464K |
| D7140 |
Extraction, erupted tooth or exposed root |
5,411 |
1,465 |
$402K |
| D9239 |
|
2,480 |
2,251 |
$171K |
| D0330 |
Panoramic radiographic image |
3,377 |
3,062 |
$150K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,701 |
3,408 |
$130K |
| D7230 |
|
218 |
143 |
$56K |
| D0140 |
Limited oral evaluation - problem focused |
536 |
486 |
$20K |
| D0220 |
Intraoral - periapical first radiographic image |
722 |
660 |
$9K |
| D0230 |
Intraoral - periapical each additional radiographic image |
449 |
154 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
87 |
26 |
$347.53 |