| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
66,875 |
53,330 |
$7.92M |
| D0120 |
Periodic oral evaluation - established patient |
19,443 |
17,415 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
6,201 |
5,970 |
$0.00 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
468 |
400 |
$0.00 |
| D1206 |
Topical application of fluoride varnish |
3,195 |
3,104 |
$0.00 |
| D1351 |
Sealant - per tooth |
281 |
101 |
$0.00 |
| D7140 |
Extraction, erupted tooth or exposed root |
1,059 |
789 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
6,230 |
5,541 |
$0.00 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,208 |
1,559 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
1,265 |
890 |
$0.00 |
| D0150 |
Comprehensive oral evaluation - new or established patient |
71 |
45 |
$0.00 |
| D5899 |
|
117 |
60 |
$0.00 |
| D0170 |
|
56 |
52 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
177 |
168 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
5,309 |
4,611 |
$0.00 |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,422 |
1,186 |
$0.00 |
| D1120 |
Prophylaxis - child |
9,686 |
9,352 |
$0.00 |
| D0274 |
Bitewings - four radiographic images |
6,084 |
5,763 |
$0.00 |
| D1110 |
Prophylaxis - adult |
7,337 |
7,006 |
$0.00 |
| D2140 |
|
86 |
76 |
$0.00 |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
13 |
12 |
$0.00 |