| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
116,440 |
98,199 |
$18.60M |
| D0220 |
Intraoral - periapical first radiographic image |
24,834 |
21,901 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
11,989 |
11,389 |
$0.00 |
| D2140 |
|
1,136 |
814 |
$0.00 |
| D1110 |
Prophylaxis - adult |
13,112 |
12,322 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
3,002 |
2,382 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
3,246 |
2,387 |
$0.00 |
| D1120 |
Prophylaxis - child |
3,903 |
3,812 |
$0.00 |
| D2940 |
|
248 |
161 |
$0.00 |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
513 |
312 |
$0.00 |
| D2950 |
|
41 |
27 |
$0.00 |
| D2332 |
|
16 |
12 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
8,860 |
8,418 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
16,281 |
15,446 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
16,030 |
8,476 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
8,233 |
7,807 |
$0.00 |
| D1351 |
Sealant - per tooth |
3,183 |
1,080 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
25,651 |
23,849 |
$0.00 |
| D0999 |
Unspecified diagnostic procedure, by report |
546 |
395 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
5,113 |
4,985 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
2,577 |
2,043 |
$0.00 |
| D2331 |
|
150 |
105 |
$0.00 |
| D9992 |
|
1,523 |
1,466 |
$0.00 |
| D9310 |
|
115 |
105 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
924 |
610 |
$0.00 |
| D2160 |
|
102 |
91 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
76 |
68 |
$0.00 |
| D9995 |
|
14 |
13 |
$0.00 |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
17 |
15 |
$0.00 |
| D2335 |
|
52 |
41 |
$0.00 |
| D2330 |
|
40 |
25 |
$0.00 |