| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
4,063 |
2,102 |
$352K |
| D9222 |
|
2,301 |
2,227 |
$291K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
2,328 |
2,251 |
$119K |
| D0330 |
Panoramic radiographic image |
2,568 |
2,567 |
$97K |
| D0140 |
Limited oral evaluation - problem focused |
1,939 |
1,935 |
$27K |
| D7140 |
Extraction, erupted tooth or exposed root |
282 |
150 |
$13K |
| D7230 |
|
69 |
61 |
$12K |
| D0120 |
Periodic oral evaluation - established patient |
323 |
321 |
$8K |
| D9310 |
|
82 |
82 |
$7K |
| D0220 |
Intraoral - periapical first radiographic image |
505 |
489 |
$6K |