| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
5,341 |
1,653 |
$1.68M |
| D7140 |
Extraction, erupted tooth or exposed root |
13,603 |
4,187 |
$956K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,975 |
1,811 |
$520K |
| D0330 |
Panoramic radiographic image |
6,075 |
5,816 |
$417K |
| D9243 |
|
4,637 |
3,161 |
$382K |
| D0140 |
Limited oral evaluation - problem focused |
6,109 |
5,845 |
$242K |
| D9239 |
|
1,464 |
1,405 |
$131K |
| D7230 |
|
425 |
222 |
$104K |
| D9222 |
|
295 |
290 |
$29K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
275 |
268 |
$27K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
581 |
559 |
$8K |
| D7220 |
|
17 |
12 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
187 |
183 |
$3K |