| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
8,495 |
5,241 |
$1.12M |
| D7140 |
Extraction, erupted tooth or exposed root |
10,999 |
3,728 |
$1.08M |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
4,450 |
3,227 |
$708K |
| D2740 |
Crown - porcelain/ceramic |
586 |
409 |
$380K |
| D0210 |
Intraoral - complete series of radiographic images |
4,096 |
4,081 |
$314K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
6,717 |
6,704 |
$263K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
2,452 |
1,577 |
$253K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
1,291 |
842 |
$204K |
| D0140 |
Limited oral evaluation - problem focused |
5,583 |
5,546 |
$186K |
| D1110 |
Prophylaxis - adult |
2,931 |
2,913 |
$127K |
| D0220 |
Intraoral - periapical first radiographic image |
8,963 |
8,841 |
$110K |
| D0274 |
Bitewings - four radiographic images |
3,682 |
3,681 |
$107K |
| D0120 |
Periodic oral evaluation - established patient |
4,411 |
4,402 |
$103K |
| D2950 |
|
815 |
689 |
$103K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,510 |
3,494 |
$64K |
| D4342 |
|
703 |
372 |
$62K |
| D2394 |
|
235 |
196 |
$45K |
| D2331 |
|
210 |
156 |
$25K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
15 |
13 |
$15K |
| D0270 |
|
1,073 |
1,072 |
$13K |
| D2335 |
|
42 |
26 |
$7K |
| D2332 |
|
18 |
12 |
$3K |
| D0460 |
|
31 |
29 |
$874.20 |
| D0330 |
Panoramic radiographic image |
12 |
12 |
$618.24 |