| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
137,322 |
129,602 |
$24.23M |
| D8670 |
Periodic orthodontic treatment visit |
6,183 |
6,183 |
$1.38M |
| D1208 |
Topical application of fluoride, excluding varnish |
29,156 |
24,810 |
$558K |
| D0120 |
Periodic oral evaluation - established patient |
43,402 |
42,945 |
$281K |
| D7140 |
Extraction, erupted tooth or exposed root |
10,425 |
8,052 |
$246K |
| D9310 |
|
11,429 |
11,386 |
$236K |
| D0140 |
Limited oral evaluation - problem focused |
30,160 |
29,410 |
$182K |
| D9999 |
Unspecified adjunctive procedure, by report |
3,212 |
2,917 |
$172K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
163 |
163 |
$154K |
| D0330 |
Panoramic radiographic image |
8,421 |
7,527 |
$143K |
| D1110 |
Prophylaxis - adult |
13,584 |
13,209 |
$137K |
| D0210 |
Intraoral - complete series of radiographic images |
7,974 |
7,331 |
$124K |
| D1120 |
Prophylaxis - child |
34,482 |
34,414 |
$114K |
| D0340 |
|
2,822 |
2,822 |
$93K |
| D1351 |
Sealant - per tooth |
8,054 |
4,084 |
$90K |
| D1206 |
Topical application of fluoride varnish |
13,097 |
12,627 |
$74K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
6,348 |
5,461 |
$73K |
| D0470 |
|
2,803 |
2,803 |
$71K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
8,007 |
7,059 |
$70K |
| D8660 |
|
2,262 |
2,262 |
$63K |
| D4341 |
|
4,962 |
2,909 |
$59K |
| D0274 |
Bitewings - four radiographic images |
11,890 |
10,906 |
$52K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
10,276 |
10,187 |
$48K |
| D9110 |
|
2,418 |
2,298 |
$38K |
| D8680 |
|
224 |
224 |
$37K |
| D0272 |
Bitewings - two radiographic images |
19,922 |
19,815 |
$37K |
| D2740 |
Crown - porcelain/ceramic |
276 |
166 |
$35K |
| D0350 |
|
3,218 |
3,218 |
$34K |
| D0220 |
Intraoral - periapical first radiographic image |
17,658 |
17,477 |
$34K |
| D2750 |
|
178 |
88 |
$33K |
| D0230 |
Intraoral - periapical each additional radiographic image |
10,902 |
10,374 |
$22K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
1,710 |
1,545 |
$22K |
| D5214 |
|
105 |
69 |
$15K |
| D4910 |
|
983 |
979 |
$14K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
735 |
552 |
$13K |
| D3320 |
|
476 |
442 |
$12K |
| D3310 |
|
240 |
205 |
$9K |
| D5110 |
|
56 |
26 |
$9K |
| D9243 |
|
185 |
121 |
$9K |
| D1354 |
|
2,871 |
1,167 |
$9K |
| D0191 |
|
3,077 |
3,076 |
$7K |
| D0240 |
|
5,699 |
5,683 |
$7K |
| D0270 |
|
1,633 |
1,552 |
$6K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
810 |
750 |
$5K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
233 |
220 |
$2K |
| D9995 |
|
1,317 |
1,311 |
$663.65 |
| D5213 |
|
18 |
13 |
$523.30 |
| D9992 |
|
15 |
14 |
$65.87 |
| D9239 |
|
92 |
92 |
$0.00 |
| D0391 |
|
46 |
46 |
$0.00 |
| D4999 |
|
12 |
12 |
$0.00 |
| D0603 |
|
16 |
16 |
$0.00 |
| D8999 |
|
328 |
304 |
$0.00 |
| D6010 |
|
13 |
13 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
28 |
25 |
$0.00 |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
14 |
14 |
$0.00 |
| D1330 |
|
33 |
33 |
$0.00 |
| D4342 |
|
40 |
26 |
$0.00 |
| D7240 |
Removal of impacted tooth - completely bony |
12 |
12 |
$0.00 |
| D2752 |
|
15 |
12 |
$0.00 |
| D0364 |
|
12 |
12 |
$0.00 |