| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
1,704 |
1,529 |
$787K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
7,430 |
7,314 |
$483K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
738 |
559 |
$285K |
| D0210 |
Intraoral - complete series of radiographic images |
2,259 |
2,207 |
$106K |
| D0330 |
Panoramic radiographic image |
3,444 |
3,398 |
$102K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
2,067 |
1,911 |
$79K |
| D9222 |
|
547 |
545 |
$66K |
| D0220 |
Intraoral - periapical first radiographic image |
4,506 |
4,447 |
$54K |
| D9430 |
|
1,520 |
1,388 |
$48K |
| D3348 |
|
103 |
100 |
$48K |
| D7240 |
Removal of impacted tooth - completely bony |
179 |
88 |
$41K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
276 |
158 |
$33K |
| D9610 |
|
863 |
591 |
$32K |
| D3320 |
|
81 |
75 |
$30K |
| D0272 |
Bitewings - two radiographic images |
2,051 |
1,890 |
$22K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,625 |
2,625 |
$15K |
| D7230 |
|
74 |
45 |
$14K |
| D9221 |
|
31 |
30 |
$10K |
| D9220 |
|
30 |
30 |
$7K |
| D9110 |
|
26 |
24 |
$1K |