| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
17,368 |
16,204 |
$408K |
| 99215 |
Prolong outpt/office vis |
4,011 |
3,881 |
$259K |
| D9920 |
|
12,506 |
10,097 |
$246K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,606 |
5,356 |
$203K |
| D1206 |
Topical application of fluoride varnish |
9,900 |
8,889 |
$106K |
| D0120 |
Periodic oral evaluation - established patient |
8,111 |
6,661 |
$69K |
| D0274 |
Bitewings - four radiographic images |
3,978 |
3,180 |
$45K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
441 |
302 |
$17K |
| 99335 |
|
369 |
361 |
$12K |
| D0230 |
Intraoral - periapical each additional radiographic image |
3,539 |
1,024 |
$10K |
| D0220 |
Intraoral - periapical first radiographic image |
2,233 |
1,781 |
$10K |
| D0140 |
Limited oral evaluation - problem focused |
249 |
241 |
$4K |
| 99443 |
|
71 |
67 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
107 |
106 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
176 |
162 |
$2K |
| 99442 |
|
103 |
97 |
$2K |
| 99348 |
|
45 |
42 |
$2K |
| D2140 |
|
35 |
26 |
$1K |
| 99334 |
|
39 |
35 |
$388.40 |
| D0272 |
Bitewings - two radiographic images |
18 |
12 |
$142.70 |
| D0210 |
Intraoral - complete series of radiographic images |
29 |
26 |
$137.72 |