| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
206,190 |
162,196 |
$30.34M |
| D9999 |
Unspecified adjunctive procedure, by report |
30,590 |
25,124 |
$4.70M |
| D8670 |
Periodic orthodontic treatment visit |
5,262 |
5,231 |
$1.04M |
| D5110 |
|
9,939 |
7,337 |
$485K |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
530 |
523 |
$411K |
| D1110 |
Prophylaxis - adult |
46,394 |
45,726 |
$373K |
| D7140 |
Extraction, erupted tooth or exposed root |
33,515 |
20,957 |
$371K |
| D0120 |
Periodic oral evaluation - established patient |
52,894 |
49,728 |
$364K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
48,253 |
46,299 |
$292K |
| D2751 |
Crown - porcelain fused to predominantly base metal |
5,868 |
4,415 |
$261K |
| D4341 |
|
20,409 |
12,266 |
$228K |
| D9310 |
|
24,990 |
24,742 |
$225K |
| D0330 |
Panoramic radiographic image |
25,608 |
25,085 |
$221K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
22,243 |
19,034 |
$213K |
| D2740 |
Crown - porcelain/ceramic |
5,875 |
4,129 |
$200K |
| D5120 |
|
6,107 |
4,735 |
$176K |
| D0140 |
Limited oral evaluation - problem focused |
32,110 |
29,982 |
$174K |
| D5214 |
|
4,692 |
3,872 |
$155K |
| D5213 |
|
3,546 |
2,841 |
$143K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
17,737 |
14,617 |
$138K |
| D0340 |
|
3,386 |
3,382 |
$127K |
| D0470 |
|
6,963 |
6,892 |
$117K |
| D2331 |
|
7,259 |
5,972 |
$102K |
| D9440 |
|
1,253 |
558 |
$101K |
| D0210 |
Intraoral - complete series of radiographic images |
18,272 |
18,028 |
$100K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
7,290 |
5,935 |
$99K |
| D8660 |
|
3,559 |
3,431 |
$98K |
| D3310 |
|
4,140 |
3,125 |
$98K |
| D3320 |
|
4,700 |
3,689 |
$87K |
| D4342 |
|
8,930 |
6,203 |
$87K |
| D3330 |
Endodontic therapy, molar tooth (excluding final restoration) |
3,899 |
3,212 |
$70K |
| D0274 |
Bitewings - four radiographic images |
27,528 |
27,296 |
$70K |
| D2330 |
|
5,073 |
3,971 |
$63K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
4,174 |
3,883 |
$54K |
| D0220 |
Intraoral - periapical first radiographic image |
34,818 |
33,726 |
$51K |
| D4910 |
|
4,415 |
4,358 |
$51K |
| D1120 |
Prophylaxis - child |
19,077 |
19,045 |
$49K |
| D1206 |
Topical application of fluoride varnish |
24,048 |
23,918 |
$45K |
| D1351 |
Sealant - per tooth |
13,606 |
6,634 |
$45K |
| D2954 |
|
2,125 |
1,961 |
$42K |
| D0350 |
|
3,742 |
3,742 |
$38K |
| D2335 |
|
1,886 |
1,594 |
$35K |
| D2332 |
|
1,896 |
1,674 |
$29K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
2,501 |
1,940 |
$28K |
| D7240 |
Removal of impacted tooth - completely bony |
776 |
508 |
$26K |
| D9944 |
|
1,461 |
1,415 |
$23K |
| D7230 |
|
1,086 |
866 |
$21K |
| D2952 |
|
817 |
664 |
$20K |
| D5211 |
|
440 |
372 |
$17K |
| D9110 |
|
2,769 |
2,716 |
$13K |
| D0272 |
Bitewings - two radiographic images |
12,461 |
12,413 |
$12K |
| D0270 |
|
11,767 |
11,643 |
$11K |
| D5212 |
|
466 |
391 |
$10K |
| D0230 |
Intraoral - periapical each additional radiographic image |
9,597 |
9,437 |
$10K |
| D9222 |
|
1,146 |
1,144 |
$9K |
| D3346 |
|
495 |
358 |
$8K |
| D0191 |
|
3,279 |
3,203 |
$7K |
| D9430 |
|
768 |
734 |
$6K |
| D1208 |
Topical application of fluoride, excluding varnish |
5,843 |
5,819 |
$6K |
| D7111 |
|
835 |
615 |
$5K |
| D3347 |
|
290 |
220 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
204 |
203 |
$4K |
| D6751 |
|
25 |
12 |
$3K |
| D0160 |
|
464 |
442 |
$3K |
| D1354 |
|
2,147 |
808 |
$3K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
578 |
556 |
$3K |
| D9940 |
|
187 |
174 |
$3K |
| D9995 |
|
699 |
656 |
$2K |
| D3348 |
|
231 |
166 |
$2K |
| D8680 |
|
13 |
13 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$1K |
| D0240 |
|
1,149 |
1,106 |
$1K |
| D2394 |
|
45 |
42 |
$1K |
| D0251 |
|
565 |
549 |
$904.72 |
| D5411 |
|
153 |
131 |
$768.52 |
| D7250 |
|
62 |
44 |
$553.50 |
| D5410 |
|
149 |
125 |
$516.53 |
| D7286 |
|
38 |
38 |
$510.70 |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
122 |
122 |
$456.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
14 |
12 |
$433.38 |
| D7220 |
|
14 |
12 |
$300.00 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
901 |
852 |
$110.00 |
| D5422 |
|
33 |
25 |
$86.61 |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
63 |
60 |
$86.38 |
| D9239 |
|
13 |
13 |
$76.00 |
| D9248 |
|
108 |
107 |
$75.00 |
| D0190 |
|
321 |
321 |
$0.00 |
| D0502 |
|
51 |
51 |
$0.00 |
| D1320 |
|
16 |
16 |
$0.00 |
| D5999 |
|
15 |
12 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
14 |
$0.00 |