| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9239 |
|
954 |
918 |
$95K |
| D9243 |
|
1,018 |
982 |
$71K |
| D7230 |
|
358 |
270 |
$52K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
499 |
405 |
$35K |
| D0330 |
Panoramic radiographic image |
1,021 |
1,020 |
$29K |
| D0140 |
Limited oral evaluation - problem focused |
1,175 |
1,073 |
$25K |
| D7140 |
Extraction, erupted tooth or exposed root |
345 |
220 |
$18K |
| D9310 |
|
311 |
311 |
$13K |
| D7240 |
Removal of impacted tooth - completely bony |
19 |
12 |
$4K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
34 |
33 |
$952.00 |
| D0220 |
Intraoral - periapical first radiographic image |
162 |
155 |
$952.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
97 |
92 |
$823.05 |
| D9920 |
|
16 |
16 |
$264.00 |