| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
29,214 |
28,369 |
$20.13M |
| D8670 |
Periodic orthodontic treatment visit |
150,848 |
105,272 |
$16.14M |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
119,689 |
34,526 |
$15.70M |
| D0120 |
Periodic oral evaluation - established patient |
341,998 |
312,985 |
$8.50M |
| D1120 |
Prophylaxis - child |
210,514 |
192,123 |
$7.02M |
| D1110 |
Prophylaxis - adult |
139,983 |
129,704 |
$6.29M |
| D7240 |
Removal of impacted tooth - completely bony |
23,470 |
7,012 |
$5.66M |
| D1206 |
Topical application of fluoride varnish |
284,102 |
269,414 |
$5.36M |
| D0272 |
Bitewings - two radiographic images |
247,624 |
227,499 |
$5.29M |
| D0210 |
Intraoral - complete series of radiographic images |
41,859 |
38,286 |
$3.12M |
| D0220 |
Intraoral - periapical first radiographic image |
174,794 |
158,712 |
$2.86M |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
106,372 |
92,381 |
$2.60M |
| D7140 |
Extraction, erupted tooth or exposed root |
40,202 |
18,311 |
$2.58M |
| D1351 |
Sealant - per tooth |
95,512 |
28,699 |
$2.43M |
| D8999 |
|
1,996 |
1,984 |
$2.38M |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
27,264 |
15,334 |
$2.10M |
| D0230 |
Intraoral - periapical each additional radiographic image |
166,185 |
127,661 |
$1.99M |
| D2140 |
|
30,683 |
18,177 |
$1.91M |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
20,349 |
8,023 |
$1.65M |
| D0140 |
Limited oral evaluation - problem focused |
51,548 |
47,093 |
$1.57M |
| D9248 |
|
16,869 |
14,948 |
$1.48M |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
19,200 |
12,176 |
$1.39M |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
18,552 |
11,059 |
$1.33M |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
22,986 |
14,855 |
$1.32M |
| D1208 |
Topical application of fluoride, excluding varnish |
52,791 |
39,735 |
$950K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
8,511 |
3,031 |
$931K |
| D9222 |
|
11,874 |
11,177 |
$917K |
| D0240 |
|
40,107 |
18,891 |
$874K |
| D0330 |
Panoramic radiographic image |
28,784 |
27,450 |
$691K |
| D7230 |
|
2,515 |
1,275 |
$550K |
| D0603 |
|
115,096 |
109,925 |
$548K |
| D7111 |
|
8,671 |
5,009 |
$389K |
| D8030 |
|
276 |
272 |
$354K |
| D8070 |
|
596 |
586 |
$286K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
8,147 |
7,975 |
$251K |
| D2934 |
|
1,771 |
617 |
$240K |
| D0274 |
Bitewings - four radiographic images |
11,584 |
11,296 |
$223K |
| D0602 |
|
42,409 |
40,496 |
$196K |
| D0601 |
|
34,732 |
32,630 |
$160K |
| D1510 |
|
801 |
569 |
$125K |
| D2330 |
|
1,206 |
722 |
$87K |
| D8090 |
|
133 |
128 |
$80K |
| D2160 |
|
842 |
549 |
$73K |
| D8020 |
|
54 |
54 |
$71K |
| D2332 |
|
535 |
305 |
$55K |
| D7220 |
|
305 |
180 |
$51K |
| D1354 |
|
3,411 |
1,383 |
$35K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
377 |
249 |
$30K |
| D2931 |
|
175 |
120 |
$25K |
| D2335 |
|
95 |
38 |
$12K |
| D0340 |
|
201 |
192 |
$8K |
| D0470 |
|
205 |
195 |
$6K |
| D9610 |
|
518 |
502 |
$5K |
| D0145 |
Oral evaluation for a patient under three years of age |
238 |
226 |
$5K |
| D7283 |
|
23 |
13 |
$5K |
| D7280 |
|
36 |
26 |
$5K |
| D0350 |
|
257 |
242 |
$4K |
| D2331 |
|
43 |
37 |
$4K |
| D1310 |
|
29 |
25 |
$50.00 |