| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
1,957 |
856 |
$116K |
| D0120 |
Periodic oral evaluation - established patient |
3,002 |
2,956 |
$70K |
| D1120 |
Prophylaxis - child |
2,726 |
2,671 |
$60K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,645 |
3,566 |
$59K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
843 |
805 |
$30K |
| D9248 |
|
613 |
517 |
$29K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,365 |
1,172 |
$26K |
| D0220 |
Intraoral - periapical first radiographic image |
3,014 |
2,933 |
$23K |
| D0230 |
Intraoral - periapical each additional radiographic image |
9,037 |
2,836 |
$21K |
| D9920 |
|
1,320 |
1,137 |
$19K |
| D9999 |
Unspecified adjunctive procedure, by report |
869 |
849 |
$17K |
| D0330 |
Panoramic radiographic image |
464 |
448 |
$17K |
| D7140 |
Extraction, erupted tooth or exposed root |
310 |
197 |
$16K |
| D1110 |
Prophylaxis - adult |
436 |
425 |
$15K |
| D0140 |
Limited oral evaluation - problem focused |
397 |
379 |
$8K |
| D2140 |
|
97 |
56 |
$5K |
| D0272 |
Bitewings - two radiographic images |
122 |
116 |
$1K |