| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
5,888 |
5,342 |
$162K |
| D0230 |
Intraoral - periapical each additional radiographic image |
5,004 |
3,465 |
$110K |
| D0120 |
Periodic oral evaluation - established patient |
6,052 |
5,477 |
$81K |
| D1999 |
|
5,300 |
4,850 |
$68K |
| D2140 |
|
1,941 |
1,101 |
$59K |
| D0272 |
Bitewings - two radiographic images |
3,662 |
3,267 |
$52K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,642 |
3,240 |
$50K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,199 |
875 |
$45K |
| D1120 |
Prophylaxis - child |
2,171 |
1,919 |
$40K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,016 |
1,797 |
$39K |
| D0220 |
Intraoral - periapical first radiographic image |
4,197 |
3,770 |
$29K |
| D7140 |
Extraction, erupted tooth or exposed root |
372 |
256 |
$13K |
| D0140 |
Limited oral evaluation - problem focused |
100 |
100 |
$1K |
| D2335 |
|
16 |
12 |
$1K |