| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2750 |
|
1,353 |
846 |
$650K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
745 |
629 |
$433K |
| D0367 |
|
1,893 |
1,850 |
$372K |
| D1110 |
Prophylaxis - adult |
1,642 |
1,597 |
$94K |
| D0140 |
Limited oral evaluation - problem focused |
1,847 |
1,801 |
$81K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
973 |
947 |
$55K |
| D2954 |
|
700 |
521 |
$55K |
| D0120 |
Periodic oral evaluation - established patient |
1,584 |
1,541 |
$41K |
| D3320 |
|
78 |
64 |
$35K |
| D0330 |
Panoramic radiographic image |
496 |
486 |
$33K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
158 |
53 |
$20K |
| D6056 |
|
42 |
26 |
$13K |
| D6058 |
|
36 |
25 |
$11K |
| D6010 |
|
19 |
12 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
461 |
445 |
$6K |
| D2950 |
|
493 |
316 |
$0.00 |