| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| D7140 |
Extraction, erupted tooth or exposed root |
3,176 |
1,801 |
$156K |
| D0330 |
Panoramic radiographic image |
2,508 |
2,381 |
$105K |
| D0140 |
Limited oral evaluation - problem focused |
2,752 |
2,523 |
$91K |
| D1110 |
Prophylaxis - adult |
1,757 |
1,658 |
$74K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,315 |
2,190 |
$62K |
| D0272 |
Bitewings - two radiographic images |
2,071 |
1,957 |
$30K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
373 |
256 |
$18K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
227 |
133 |
$14K |
| D0220 |
Intraoral - periapical first radiographic image |
1,424 |
1,333 |
$11K |
| D2335 |
|
150 |
93 |
$11K |
| D1120 |
Prophylaxis - child |
60 |
58 |
$3K |
| D2140 |
|
60 |
40 |
$2K |
| D2331 |
|
53 |
29 |
$2K |
| D1208 |
Topical application of fluoride, excluding varnish |
60 |
58 |
$890.40 |
| D9110 |
|
14 |
14 |
$867.30 |
| D2160 |
|
19 |
13 |
$805.00 |
| D9995 |
|
120 |
114 |
$50.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
43 |
37 |
$0.00 |
| D1999 |
|
67 |
57 |
$0.00 |