| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0120 |
Periodic oral evaluation - established patient |
100,289 |
99,928 |
$5.68M |
| D1120 |
Prophylaxis - child |
126,220 |
125,785 |
$4.94M |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
36,630 |
20,990 |
$2.38M |
| D1310 |
|
44,561 |
44,433 |
$2.04M |
| D1351 |
Sealant - per tooth |
53,604 |
16,602 |
$1.61M |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
35,389 |
34,492 |
$1.39M |
| D9993 |
|
20,764 |
20,757 |
$1.34M |
| D2930 |
Prefabricated stainless steel crown - primary tooth |
9,192 |
6,413 |
$1.06M |
| D1206 |
Topical application of fluoride varnish |
41,274 |
41,171 |
$950K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
14,312 |
14,274 |
$929K |
| D0274 |
Bitewings - four radiographic images |
43,447 |
43,272 |
$891K |
| D1208 |
Topical application of fluoride, excluding varnish |
82,033 |
81,714 |
$867K |
| D7140 |
Extraction, erupted tooth or exposed root |
14,129 |
8,968 |
$793K |
| D0145 |
Oral evaluation for a patient under three years of age |
10,138 |
10,113 |
$630K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
11,338 |
8,125 |
$601K |
| D0230 |
Intraoral - periapical each additional radiographic image |
144,675 |
87,812 |
$573K |
| D0603 |
|
37,506 |
37,414 |
$559K |
| D0272 |
Bitewings - two radiographic images |
46,874 |
46,725 |
$542K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
5,495 |
4,426 |
$428K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
3,697 |
2,775 |
$362K |
| D0270 |
|
44,686 |
44,361 |
$222K |
| D0350 |
|
21,105 |
14,036 |
$212K |
| D0220 |
Intraoral - periapical first radiographic image |
16,606 |
16,427 |
$188K |
| D9430 |
|
5,683 |
5,622 |
$180K |
| D2940 |
|
2,112 |
1,003 |
$116K |
| D0601 |
|
4,225 |
4,212 |
$63K |
| D2330 |
|
724 |
507 |
$55K |
| D0210 |
Intraoral - complete series of radiographic images |
873 |
856 |
$40K |
| D1354 |
|
2,985 |
945 |
$31K |
| D2941 |
|
483 |
203 |
$19K |
| D0330 |
Panoramic radiographic image |
491 |
491 |
$15K |
| D1510 |
|
134 |
123 |
$14K |
| D0602 |
|
515 |
515 |
$8K |
| D2335 |
|
32 |
24 |
$4K |
| D9221 |
|
27 |
22 |
$3K |
| D9220 |
|
22 |
22 |
$3K |
| D9995 |
|
328 |
326 |
$2K |
| D2331 |
|
17 |
15 |
$1K |
| D2394 |
|
15 |
12 |
$1K |
| D2332 |
|
15 |
12 |
$1K |
| D4910 |
|
13 |
13 |
$1K |
| D9610 |
|
29 |
22 |
$966.00 |
| D9999 |
Unspecified adjunctive procedure, by report |
1,016 |
99 |
$651.84 |
| D0999 |
Unspecified diagnostic procedure, by report |
62 |
62 |
$14.40 |
| D9996 |
|
261 |
260 |
$0.00 |