| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9410 |
|
257,130 |
207,423 |
$7.17M |
| D9920 |
|
60,295 |
53,961 |
$4.44M |
| D4910 |
|
36,326 |
36,246 |
$2.91M |
| D4341 |
|
27,101 |
8,207 |
$2.58M |
| D1110 |
Prophylaxis - adult |
29,633 |
29,578 |
$2.58M |
| D4355 |
|
22,215 |
22,155 |
$2.27M |
| D9110 |
|
35,359 |
35,224 |
$2.22M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
28,025 |
27,968 |
$1.73M |
| D0120 |
Periodic oral evaluation - established patient |
20,571 |
20,504 |
$1.42M |
| D0230 |
Intraoral - periapical each additional radiographic image |
37,731 |
33,011 |
$1.24M |
| D1208 |
Topical application of fluoride, excluding varnish |
46,304 |
46,210 |
$662K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,709 |
1,118 |
$435K |
| D0220 |
Intraoral - periapical first radiographic image |
33,576 |
33,363 |
$396K |
| D4342 |
|
5,300 |
2,776 |
$357K |
| D0210 |
Intraoral - complete series of radiographic images |
3,657 |
3,656 |
$175K |
| D5120 |
|
167 |
167 |
$104K |
| D5410 |
|
2,792 |
2,786 |
$97K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,717 |
650 |
$97K |
| D5411 |
|
2,303 |
2,300 |
$80K |
| D5110 |
|
128 |
128 |
$80K |
| D5751 |
|
12 |
12 |
$2K |
| D5422 |
|
30 |
30 |
$1K |
| D5851 |
|
13 |
13 |
$910.00 |
| D5850 |
|
12 |
12 |
$840.00 |
| D5421 |
|
12 |
12 |
$420.00 |