| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
97,379 |
93,076 |
$4.65M |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
1,761 |
1,722 |
$3.30M |
| D0120 |
Periodic oral evaluation - established patient |
81,885 |
78,409 |
$1.67M |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
25,017 |
14,947 |
$1.63M |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
14,583 |
8,390 |
$1.58M |
| D1208 |
Topical application of fluoride, excluding varnish |
105,910 |
100,912 |
$1.54M |
| D0330 |
Panoramic radiographic image |
36,773 |
35,192 |
$1.44M |
| D1110 |
Prophylaxis - adult |
29,148 |
28,004 |
$1.43M |
| D1351 |
Sealant - per tooth |
73,357 |
20,803 |
$1.37M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
48,292 |
46,217 |
$1.29M |
| D8670 |
Periodic orthodontic treatment visit |
1,637 |
1,557 |
$1.21M |
| D0272 |
Bitewings - two radiographic images |
74,405 |
70,397 |
$1.17M |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
20,279 |
12,594 |
$985K |
| D7240 |
Removal of impacted tooth - completely bony |
6,184 |
1,667 |
$966K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
28,676 |
25,848 |
$889K |
| D0274 |
Bitewings - four radiographic images |
33,493 |
32,124 |
$771K |
| D7140 |
Extraction, erupted tooth or exposed root |
14,535 |
7,516 |
$698K |
| D0220 |
Intraoral - periapical first radiographic image |
68,112 |
64,788 |
$634K |
| D2140 |
|
11,988 |
8,279 |
$524K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
5,772 |
4,007 |
$426K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
7,273 |
5,216 |
$418K |
| D0140 |
Limited oral evaluation - problem focused |
11,732 |
11,187 |
$388K |
| D0230 |
Intraoral - periapical each additional radiographic image |
56,782 |
51,808 |
$374K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
2,977 |
1,521 |
$311K |
| D1206 |
Topical application of fluoride varnish |
15,854 |
15,664 |
$264K |
| D8660 |
|
2,044 |
1,983 |
$144K |
| D2332 |
|
1,280 |
786 |
$92K |
| D7230 |
|
595 |
337 |
$75K |
| D7111 |
|
1,535 |
1,006 |
$75K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
1,189 |
793 |
$74K |
| D2330 |
|
1,007 |
691 |
$51K |
| D2335 |
|
477 |
278 |
$40K |
| D1352 |
|
998 |
210 |
$36K |
| D8999 |
|
330 |
239 |
$35K |
| D4341 |
|
425 |
165 |
$25K |
| D0210 |
Intraoral - complete series of radiographic images |
457 |
438 |
$16K |
| D0270 |
|
2,286 |
2,166 |
$15K |
| D0180 |
|
223 |
221 |
$13K |
| D0160 |
|
174 |
161 |
$12K |
| D1353 |
|
514 |
119 |
$8K |
| D2394 |
|
93 |
69 |
$7K |
| D2331 |
|
92 |
71 |
$6K |
| D2160 |
|
71 |
50 |
$4K |
| D3120 |
|
68 |
52 |
$3K |
| D4355 |
|
87 |
83 |
$3K |
| D0340 |
|
64 |
61 |
$219.96 |
| D1999 |
|
17,255 |
15,068 |
$0.00 |
| D7922 |
|
293 |
136 |
$0.00 |
| D9110 |
|
12 |
12 |
$0.00 |
| D0240 |
|
107 |
107 |
$0.00 |
| D9310 |
|
54 |
50 |
$0.00 |