| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0999 |
Unspecified diagnostic procedure, by report |
20,062 |
16,935 |
$2.28M |
| D0140 |
Limited oral evaluation - problem focused |
4,140 |
3,991 |
$17K |
| D1120 |
Prophylaxis - child |
5,134 |
4,891 |
$11K |
| D7140 |
Extraction, erupted tooth or exposed root |
2,619 |
2,096 |
$7K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,538 |
3,421 |
$6K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,041 |
1,648 |
$5K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,676 |
1,321 |
$4K |
| D0120 |
Periodic oral evaluation - established patient |
4,146 |
3,912 |
$4K |
| D0274 |
Bitewings - four radiographic images |
2,606 |
2,521 |
$3K |
| D1206 |
Topical application of fluoride varnish |
5,876 |
5,586 |
$2K |
| D0272 |
Bitewings - two radiographic images |
943 |
895 |
$469.80 |
| D1110 |
Prophylaxis - adult |
274 |
259 |
$441.60 |
| D0220 |
Intraoral - periapical first radiographic image |
4,640 |
4,499 |
$397.85 |
| D1351 |
Sealant - per tooth |
719 |
279 |
$144.00 |
| D0270 |
|
934 |
931 |
$28.00 |
| D0330 |
Panoramic radiographic image |
1,976 |
1,904 |
$15.58 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,695 |
2,304 |
$3.80 |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
12 |
12 |
$0.00 |
| D1354 |
|
31 |
14 |
$0.00 |
| D0603 |
|
183 |
172 |
$0.00 |
| D0602 |
|
612 |
556 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
430 |
428 |
$0.00 |
| D0601 |
|
1,489 |
1,360 |
$0.00 |
| D1330 |
|
43 |
41 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
51 |
47 |
$0.00 |