| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9243 |
|
11,799 |
2,891 |
$2.43M |
| D9239 |
|
3,585 |
2,904 |
$1.67M |
| D7140 |
Extraction, erupted tooth or exposed root |
9,260 |
2,084 |
$873K |
| D2332 |
|
2,527 |
385 |
$322K |
| D5130 |
|
317 |
281 |
$319K |
| D5226 |
|
285 |
236 |
$288K |
| D0330 |
Panoramic radiographic image |
3,275 |
3,109 |
$236K |
| D0140 |
Limited oral evaluation - problem focused |
4,252 |
4,093 |
$174K |
| D5225 |
|
170 |
142 |
$172K |
| D5214 |
|
161 |
142 |
$169K |
| D5213 |
|
119 |
105 |
$124K |
| D2740 |
Crown - porcelain/ceramic |
83 |
51 |
$88K |
| D1110 |
Prophylaxis - adult |
1,376 |
1,327 |
$86K |
| D2950 |
|
479 |
319 |
$85K |
| D3320 |
|
165 |
113 |
$67K |
| D5140 |
|
65 |
56 |
$63K |
| D0274 |
Bitewings - four radiographic images |
1,525 |
1,464 |
$62K |
| D5212 |
|
70 |
64 |
$57K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,384 |
1,320 |
$56K |
| D5211 |
|
61 |
53 |
$40K |
| D0220 |
Intraoral - periapical first radiographic image |
2,537 |
2,435 |
$40K |
| D2710 |
|
81 |
59 |
$31K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
44 |
39 |
$25K |
| D7240 |
Removal of impacted tooth - completely bony |
58 |
29 |
$18K |
| D3310 |
|
40 |
27 |
$14K |
| D2335 |
|
96 |
49 |
$14K |
| D0120 |
Periodic oral evaluation - established patient |
339 |
331 |
$11K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
119 |
64 |
$11K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,100 |
661 |
$11K |
| D1330 |
|
92 |
90 |
$3K |
| D1206 |
Topical application of fluoride varnish |
78 |
71 |
$2K |
| D1120 |
Prophylaxis - child |
50 |
48 |
$2K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
22 |
12 |
$2K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
13 |
12 |
$2K |