| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7240 |
Removal of impacted tooth - completely bony |
7,726 |
2,253 |
$1.16M |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
1,353 |
1,163 |
$687K |
| D9243 |
|
12,182 |
1,757 |
$578K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
5,008 |
1,698 |
$400K |
| D9248 |
|
4,102 |
3,802 |
$215K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,557 |
3,405 |
$114K |
| D9239 |
|
1,776 |
1,687 |
$92K |
| D2394 |
|
1,163 |
785 |
$89K |
| D9630 |
|
2,012 |
1,906 |
$80K |
| D0140 |
Limited oral evaluation - problem focused |
3,188 |
3,007 |
$70K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
767 |
431 |
$57K |
| D0330 |
Panoramic radiographic image |
3,442 |
3,282 |
$33K |
| D0220 |
Intraoral - periapical first radiographic image |
3,533 |
3,303 |
$29K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
306 |
210 |
$19K |
| D3310 |
|
44 |
24 |
$18K |
| D2335 |
|
162 |
58 |
$15K |
| D1999 |
|
748 |
649 |
$9K |
| D7140 |
Extraction, erupted tooth or exposed root |
229 |
63 |
$8K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,046 |
2,052 |
$7K |
| D9612 |
|
129 |
128 |
$6K |
| D7310 |
|
26 |
12 |
$5K |
| D9110 |
|
79 |
75 |
$4K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
58 |
41 |
$3K |
| D0460 |
|
361 |
342 |
$2K |
| D0274 |
Bitewings - four radiographic images |
54 |
54 |
$802.71 |