| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
1,270 |
1,061 |
$853K |
| D0140 |
Limited oral evaluation - problem focused |
1,218 |
1,158 |
$23K |
| D2950 |
|
1,052 |
844 |
$21K |
| D3310 |
|
35 |
25 |
$16K |
| D9310 |
|
364 |
358 |
$11K |
| D3320 |
|
12 |
12 |
$8K |
| D0330 |
Panoramic radiographic image |
64 |
64 |
$3K |
| D0220 |
Intraoral - periapical first radiographic image |
1,686 |
1,579 |
$2K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
180 |
150 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
193 |
182 |
$95.84 |
| D9920 |
|
65 |
29 |
$80.25 |
| D0272 |
Bitewings - two radiographic images |
17 |
14 |
$0.00 |
| D0270 |
|
13 |
12 |
$0.00 |