| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
575 |
204 |
$41K |
| D0140 |
Limited oral evaluation - problem focused |
263 |
245 |
$4K |
| D7140 |
Extraction, erupted tooth or exposed root |
55 |
27 |
$3K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
98 |
95 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
81 |
79 |
$2K |
| D0330 |
Panoramic radiographic image |
66 |
60 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
157 |
143 |
$851.20 |
| D0210 |
Intraoral - complete series of radiographic images |
32 |
31 |
$737.70 |
| D0270 |
|
29 |
29 |
$162.40 |