| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
7,558 |
7,533 |
$1.40M |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
226 |
226 |
$215K |
| D0340 |
|
3,120 |
3,120 |
$136K |
| D0330 |
Panoramic radiographic image |
3,699 |
3,699 |
$121K |
| D0470 |
|
3,351 |
3,351 |
$105K |
| D8660 |
|
3,564 |
3,561 |
$103K |
| D0367 |
|
234 |
234 |
$65K |
| D1110 |
Prophylaxis - adult |
1,211 |
1,210 |
$50K |
| D0120 |
Periodic oral evaluation - established patient |
2,269 |
2,267 |
$39K |
| D9223 |
Deep sedation/general anesthesia - each subsequent 15 minute increment |
364 |
363 |
$39K |
| D0350 |
|
3,408 |
3,408 |
$38K |
| D9222 |
|
418 |
417 |
$29K |
| D9310 |
|
578 |
577 |
$15K |
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
171 |
90 |
$14K |
| D0140 |
Limited oral evaluation - problem focused |
673 |
671 |
$9K |
| D8680 |
|
196 |
196 |
$9K |
| D0274 |
Bitewings - four radiographic images |
336 |
336 |
$8K |
| D7140 |
Extraction, erupted tooth or exposed root |
103 |
55 |
$5K |
| D0230 |
Intraoral - periapical each additional radiographic image |
406 |
406 |
$4K |
| D0220 |
Intraoral - periapical first radiographic image |
453 |
453 |
$4K |
| D9610 |
|
28 |
28 |
$216.50 |
| D9999 |
Unspecified adjunctive procedure, by report |
1,234 |
1,095 |
$0.00 |