| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
823 |
683 |
$274K |
| D9310 |
|
1,467 |
1,453 |
$84K |
| D0330 |
Panoramic radiographic image |
1,379 |
1,368 |
$51K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
405 |
220 |
$39K |
| D3320 |
|
187 |
145 |
$32K |
| D0220 |
Intraoral - periapical first radiographic image |
1,406 |
1,185 |
$9K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
15 |
15 |
$506.10 |
| D0140 |
Limited oral evaluation - problem focused |
12 |
12 |
$0.00 |