| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
535 |
468 |
$433K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,828 |
921 |
$389K |
| D2740 |
Crown - porcelain/ceramic |
495 |
323 |
$382K |
| D7240 |
Removal of impacted tooth - completely bony |
792 |
379 |
$331K |
| D7241 |
|
576 |
331 |
$327K |
| D0140 |
Limited oral evaluation - problem focused |
2,291 |
2,284 |
$192K |
| D7230 |
|
503 |
343 |
$172K |
| D0330 |
Panoramic radiographic image |
1,504 |
1,500 |
$138K |
| D2950 |
|
795 |
626 |
$95K |
| D3310 |
|
113 |
60 |
$71K |
| D3320 |
|
101 |
90 |
$61K |
| D0220 |
Intraoral - periapical first radiographic image |
1,123 |
1,086 |
$23K |
| D7220 |
|
98 |
70 |
$23K |
| D2954 |
|
121 |
64 |
$21K |
| D7250 |
|
94 |
53 |
$20K |
| D0272 |
Bitewings - two radiographic images |
288 |
288 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
906 |
688 |
$6K |
| D0270 |
|
121 |
120 |
$1K |