| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
23,162 |
19,190 |
$606K |
| D0230 |
Intraoral - periapical each additional radiographic image |
68,093 |
15,980 |
$435K |
| D1999 |
|
23,645 |
19,450 |
$356K |
| D0120 |
Periodic oral evaluation - established patient |
18,445 |
15,324 |
$247K |
| D0272 |
Bitewings - two radiographic images |
17,077 |
14,134 |
$238K |
| D7140 |
Extraction, erupted tooth or exposed root |
4,690 |
2,726 |
$208K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
9,942 |
8,201 |
$193K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
3,514 |
2,125 |
$133K |
| D0220 |
Intraoral - periapical first radiographic image |
18,838 |
15,718 |
$131K |
| D1208 |
Topical application of fluoride, excluding varnish |
9,004 |
7,306 |
$125K |
| D1120 |
Prophylaxis - child |
4,642 |
3,844 |
$83K |
| D7220 |
|
636 |
313 |
$66K |
| D1351 |
Sealant - per tooth |
4,298 |
567 |
$62K |
| D2140 |
|
1,691 |
1,048 |
$45K |
| D7230 |
|
281 |
96 |
$35K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
809 |
551 |
$33K |
| D7250 |
|
623 |
377 |
$25K |
| D2160 |
|
136 |
116 |
$6K |
| D2335 |
|
70 |
38 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
163 |
125 |
$3K |
| D3320 |
|
20 |
14 |
$3K |
| D2940 |
|
12 |
12 |
$226.00 |