| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0601 |
|
722 |
658 |
$0.00 |
| D1310 |
|
1,075 |
975 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
199 |
185 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
700 |
635 |
$0.00 |
| D0602 |
|
194 |
183 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
277 |
247 |
$0.00 |
| D0603 |
|
133 |
117 |
$0.00 |
| D1351 |
Sealant - per tooth |
95 |
28 |
$0.00 |
| D1330 |
|
1,079 |
976 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
43 |
24 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
141 |
130 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
104 |
91 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
716 |
651 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
295 |
273 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
12 |
12 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
402 |
360 |
$0.00 |
| D1110 |
Prophylaxis - adult |
425 |
385 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
492 |
456 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
14 |
14 |
$0.00 |
| D1120 |
Prophylaxis - child |
464 |
416 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
254 |
179 |
$0.00 |
| D2140 |
|
68 |
52 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
16 |
12 |
$0.00 |