| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,823 |
1,706 |
$47K |
| D1999 |
|
3,059 |
2,847 |
$45K |
| D0120 |
Periodic oral evaluation - established patient |
3,244 |
3,025 |
$41K |
| D7140 |
Extraction, erupted tooth or exposed root |
573 |
422 |
$19K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
144 |
88 |
$15K |
| D2335 |
|
155 |
108 |
$9K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
337 |
311 |
$7K |
| D1208 |
Topical application of fluoride, excluding varnish |
388 |
329 |
$5K |
| D2161 |
|
80 |
71 |
$5K |
| D1120 |
Prophylaxis - child |
193 |
160 |
$3K |
| D2140 |
|
55 |
30 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
25 |
25 |
$213.40 |