| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
19,194 |
3,955 |
$1.91M |
| D7240 |
Removal of impacted tooth - completely bony |
8,138 |
3,358 |
$1.64M |
| D0140 |
Limited oral evaluation - problem focused |
10,072 |
8,918 |
$276K |
| D3310 |
|
471 |
330 |
$211K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
3,176 |
2,991 |
$100K |
| D0220 |
Intraoral - periapical first radiographic image |
9,439 |
8,408 |
$92K |
| D0230 |
Intraoral - periapical each additional radiographic image |
19,958 |
7,771 |
$40K |
| D2332 |
|
310 |
210 |
$35K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
273 |
249 |
$27K |
| D7320 |
|
97 |
39 |
$22K |
| D7311 |
|
106 |
70 |
$19K |
| D7230 |
|
112 |
52 |
$12K |
| D7310 |
|
55 |
25 |
$9K |
| D0330 |
Panoramic radiographic image |
330 |
313 |
$6K |
| D1999 |
|
491 |
444 |
$6K |
| D2330 |
|
33 |
24 |
$2K |