| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
10,362 |
8,660 |
$1.14M |
| D0274 |
Bitewings - four radiographic images |
1,568 |
1,466 |
$0.00 |
| D1120 |
Prophylaxis - child |
4,212 |
3,957 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
973 |
789 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
1,758 |
1,659 |
$0.00 |
| D1110 |
Prophylaxis - adult |
321 |
303 |
$0.00 |
| D1354 |
|
56 |
26 |
$0.00 |
| D0270 |
|
12 |
12 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
373 |
333 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,285 |
1,186 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
307 |
263 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
459 |
424 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
4,785 |
4,489 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
4,229 |
3,969 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
709 |
571 |
$0.00 |
| D1351 |
Sealant - per tooth |
775 |
427 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
550 |
515 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
123 |
76 |
$0.00 |
| D1330 |
|
822 |
703 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
17 |
12 |
$0.00 |
| D0602 |
|
66 |
63 |
$0.00 |
| D0603 |
|
40 |
39 |
$0.00 |