| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9410 |
|
297,919 |
279,555 |
$7.38M |
| D9999 |
Unspecified adjunctive procedure, by report |
30,712 |
22,890 |
$6.04M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
77,571 |
77,184 |
$4.64M |
| D1110 |
Prophylaxis - adult |
51,008 |
50,831 |
$4.30M |
| D0120 |
Periodic oral evaluation - established patient |
66,024 |
65,773 |
$3.38M |
| D4355 |
|
25,024 |
24,949 |
$2.52M |
| D4910 |
|
30,669 |
30,235 |
$2.37M |
| D9920 |
|
24,361 |
24,006 |
$2.06M |
| D0230 |
Intraoral - periapical each additional radiographic image |
607,138 |
60,056 |
$1.95M |
| D1206 |
Topical application of fluoride varnish |
72,659 |
72,432 |
$1.20M |
| D4341 |
|
13,075 |
3,891 |
$800K |
| D0220 |
Intraoral - periapical first radiographic image |
61,010 |
60,425 |
$651K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
7,628 |
2,816 |
$432K |
| D5850 |
|
4,185 |
4,166 |
$284K |
| D5120 |
|
698 |
666 |
$272K |
| D5110 |
|
757 |
710 |
$258K |
| D5851 |
|
3,183 |
3,172 |
$216K |
| D4342 |
|
371 |
194 |
$24K |
| D7140 |
Extraction, erupted tooth or exposed root |
444 |
206 |
$17K |
| D2330 |
|
69 |
39 |
$5K |
| D0210 |
Intraoral - complete series of radiographic images |
32 |
32 |
$2K |
| D2332 |
|
109 |
27 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
67 |
25 |
$0.00 |
| 40808 |
|
12 |
12 |
$0.00 |
| D5411 |
|
15 |
14 |
$0.00 |
| D5211 |
|
28 |
28 |
$0.00 |
| D5422 |
|
43 |
43 |
$0.00 |
| D5212 |
|
46 |
46 |
$0.00 |
| D5410 |
|
14 |
13 |
$0.00 |