| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0330 |
Panoramic radiographic image |
1,847 |
1,698 |
$41K |
| D1110 |
Prophylaxis - adult |
1,692 |
1,521 |
$38K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,197 |
1,968 |
$36K |
| D0272 |
Bitewings - two radiographic images |
1,641 |
1,501 |
$20K |
| D7140 |
Extraction, erupted tooth or exposed root |
481 |
335 |
$12K |
| D0210 |
Intraoral - complete series of radiographic images |
306 |
229 |
$12K |
| D1999 |
|
279 |
255 |
$5K |
| D0120 |
Periodic oral evaluation - established patient |
414 |
373 |
$4K |
| D1120 |
Prophylaxis - child |
240 |
209 |
$4K |
| D1208 |
Topical application of fluoride, excluding varnish |
156 |
134 |
$2K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
31 |
25 |
$937.14 |
| D2140 |
|
17 |
13 |
$382.28 |
| D2160 |
|
13 |
12 |
$370.10 |