| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,836 |
2,761 |
$283K |
| D7240 |
Removal of impacted tooth - completely bony |
650 |
459 |
$161K |
| D0330 |
Panoramic radiographic image |
4,109 |
4,102 |
$106K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,278 |
867 |
$68K |
| D0160 |
|
2,797 |
2,793 |
$50K |
| D7230 |
|
324 |
297 |
$41K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
561 |
558 |
$38K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,312 |
1,307 |
$30K |
| D9222 |
|
445 |
442 |
$29K |
| D9243 |
|
188 |
184 |
$13K |
| D9310 |
|
283 |
283 |
$12K |
| D9239 |
|
119 |
117 |
$5K |
| D0140 |
Limited oral evaluation - problem focused |
86 |
84 |
$0.00 |