| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
1,982 |
1,880 |
$33K |
| D1110 |
Prophylaxis - adult |
1,003 |
939 |
$32K |
| D0272 |
Bitewings - two radiographic images |
1,891 |
1,777 |
$29K |
| D1208 |
Topical application of fluoride, excluding varnish |
2,120 |
2,005 |
$28K |
| D1120 |
Prophylaxis - child |
858 |
820 |
$22K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
860 |
691 |
$16K |
| D0330 |
Panoramic radiographic image |
403 |
372 |
$15K |
| D1999 |
|
289 |
278 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
113 |
101 |
$2K |
| D1206 |
Topical application of fluoride varnish |
16 |
16 |
$365.40 |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
12 |
$110.00 |