| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
13,013 |
5,539 |
$705K |
| D0210 |
Intraoral - complete series of radiographic images |
5,542 |
5,175 |
$269K |
| D0330 |
Panoramic radiographic image |
6,134 |
5,667 |
$261K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
4,316 |
2,373 |
$225K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
7,553 |
7,178 |
$186K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
514 |
452 |
$183K |
| D0140 |
Limited oral evaluation - problem focused |
6,450 |
5,935 |
$142K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,729 |
1,450 |
$124K |
| D2950 |
|
1,460 |
1,228 |
$108K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
1,518 |
1,038 |
$96K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,703 |
900 |
$95K |
| D3320 |
|
300 |
260 |
$85K |
| D1110 |
Prophylaxis - adult |
1,203 |
1,112 |
$36K |
| D0274 |
Bitewings - four radiographic images |
1,972 |
1,863 |
$35K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
504 |
253 |
$27K |
| D0120 |
Periodic oral evaluation - established patient |
1,469 |
1,422 |
$25K |
| D2394 |
|
280 |
232 |
$20K |
| D2335 |
|
198 |
132 |
$17K |
| D0220 |
Intraoral - periapical first radiographic image |
3,393 |
3,136 |
$16K |
| D7230 |
|
112 |
65 |
$15K |
| D2160 |
|
137 |
89 |
$9K |
| D2931 |
|
70 |
56 |
$8K |
| D7240 |
Removal of impacted tooth - completely bony |
37 |
15 |
$7K |
| D2140 |
|
169 |
88 |
$7K |
| D2331 |
|
107 |
70 |
$6K |
| D2330 |
|
104 |
69 |
$5K |
| D7220 |
|
47 |
25 |
$4K |
| D0230 |
Intraoral - periapical each additional radiographic image |
743 |
502 |
$3K |
| D2332 |
|
38 |
25 |
$3K |
| D0270 |
|
44 |
38 |
$192.50 |