| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,607 |
1,292 |
$36K |
| D1110 |
Prophylaxis - adult |
768 |
730 |
$29K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
298 |
284 |
$15K |
| D0330 |
Panoramic radiographic image |
202 |
195 |
$11K |
| D1208 |
Topical application of fluoride, excluding varnish |
280 |
264 |
$6K |
| D0120 |
Periodic oral evaluation - established patient |
122 |
121 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
34 |
12 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
133 |
118 |
$1K |
| D0272 |
Bitewings - two radiographic images |
64 |
63 |
$1K |
| D9212 |
|
18 |
14 |
$882.00 |