| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
33,107 |
32,630 |
$1.29M |
| D0120 |
Periodic oral evaluation - established patient |
45,115 |
44,656 |
$1.26M |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
8,930 |
4,742 |
$1.15M |
| D1206 |
Topical application of fluoride varnish |
33,262 |
32,695 |
$754K |
| D1110 |
Prophylaxis - adult |
10,850 |
10,728 |
$579K |
| D0272 |
Bitewings - two radiographic images |
17,578 |
17,322 |
$456K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
7,694 |
7,447 |
$435K |
| D1351 |
Sealant - per tooth |
7,946 |
2,602 |
$254K |
| D0140 |
Limited oral evaluation - problem focused |
6,125 |
5,852 |
$254K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
5,115 |
4,958 |
$230K |
| D1208 |
Topical application of fluoride, excluding varnish |
11,346 |
11,273 |
$202K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,685 |
1,085 |
$157K |
| D1330 |
|
6,562 |
6,429 |
$108K |
| D7140 |
Extraction, erupted tooth or exposed root |
794 |
336 |
$74K |
| D0220 |
Intraoral - periapical first radiographic image |
4,034 |
3,890 |
$72K |
| D0330 |
Panoramic radiographic image |
685 |
674 |
$43K |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
278 |
93 |
$41K |
| D9420 |
|
243 |
224 |
$32K |
| D0274 |
Bitewings - four radiographic images |
710 |
698 |
$28K |
| D1354 |
|
1,416 |
673 |
$21K |
| D0470 |
|
149 |
144 |
$8K |
| D0350 |
|
201 |
195 |
$6K |
| D0340 |
|
83 |
78 |
$5K |
| D9920 |
|
65 |
64 |
$3K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
41 |
37 |
$2K |
| D2330 |
|
20 |
13 |
$2K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
16 |
12 |
$1K |
| D0230 |
Intraoral - periapical each additional radiographic image |
118 |
40 |
$651.00 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
13 |
13 |
$153.00 |