| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
3,090 |
2,997 |
$133K |
| D0120 |
Periodic oral evaluation - established patient |
2,645 |
2,573 |
$87K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,931 |
2,842 |
$80K |
| D0220 |
Intraoral - periapical first radiographic image |
1,575 |
1,517 |
$28K |
| D0240 |
|
1,049 |
1,021 |
$19K |
| D0272 |
Bitewings - two radiographic images |
225 |
210 |
$6K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
98 |
96 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
371 |
198 |
$6K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
98 |
90 |
$5K |
| D1206 |
Topical application of fluoride varnish |
138 |
137 |
$4K |
| D0274 |
Bitewings - four radiographic images |
78 |
76 |
$3K |
| D1999 |
|
118 |
111 |
$0.00 |