| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
5,051 |
4,177 |
$128K |
| D1999 |
|
6,575 |
5,391 |
$88K |
| D0120 |
Periodic oral evaluation - established patient |
5,897 |
4,789 |
$70K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,684 |
1,070 |
$68K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,687 |
2,972 |
$50K |
| D0330 |
Panoramic radiographic image |
1,722 |
1,530 |
$47K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,396 |
2,016 |
$46K |
| D0272 |
Bitewings - two radiographic images |
3,076 |
2,616 |
$43K |
| D0210 |
Intraoral - complete series of radiographic images |
1,188 |
933 |
$42K |
| D1120 |
Prophylaxis - child |
2,391 |
1,922 |
$41K |
| D0140 |
Limited oral evaluation - problem focused |
2,136 |
1,784 |
$35K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
403 |
310 |
$26K |
| D0220 |
Intraoral - periapical first radiographic image |
4,987 |
4,183 |
$26K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
486 |
308 |
$14K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,425 |
2,907 |
$14K |
| D2160 |
|
232 |
168 |
$7K |
| D2335 |
|
146 |
87 |
$6K |
| D7230 |
|
20 |
12 |
$2K |
| D2140 |
|
104 |
50 |
$2K |