| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D9110 |
|
11,326 |
7,574 |
$573K |
| D4341 |
|
11,103 |
2,795 |
$325K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
3,091 |
1,497 |
$220K |
| D7311 |
|
1,200 |
999 |
$211K |
| D0140 |
Limited oral evaluation - problem focused |
3,480 |
2,835 |
$103K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,140 |
2,114 |
$67K |
| D0220 |
Intraoral - periapical first radiographic image |
8,168 |
6,074 |
$66K |
| D0274 |
Bitewings - four radiographic images |
3,298 |
3,262 |
$36K |
| D2140 |
|
1,072 |
414 |
$34K |
| D0120 |
Periodic oral evaluation - established patient |
1,030 |
1,021 |
$30K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
413 |
259 |
$18K |
| D1110 |
Prophylaxis - adult |
221 |
217 |
$7K |
| D7250 |
|
90 |
37 |
$6K |
| D2335 |
|
40 |
27 |
$3K |
| D2160 |
|
48 |
37 |
$3K |
| D2161 |
|
29 |
27 |
$2K |
| D0230 |
Intraoral - periapical each additional radiographic image |
805 |
534 |
$1K |
| D2332 |
|
18 |
12 |
$1K |