| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1206 |
Topical application of fluoride varnish |
1,020 |
972 |
$19K |
| D0120 |
Periodic oral evaluation - established patient |
866 |
823 |
$18K |
| D1120 |
Prophylaxis - child |
681 |
645 |
$16K |
| D1110 |
Prophylaxis - adult |
316 |
302 |
$11K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
275 |
262 |
$10K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
112 |
73 |
$6K |
| D0603 |
|
548 |
515 |
$5K |
| D0272 |
Bitewings - two radiographic images |
310 |
293 |
$5K |
| D1330 |
|
694 |
651 |
$3K |
| D0274 |
Bitewings - four radiographic images |
81 |
80 |
$2K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
62 |
62 |
$1K |
| D9920 |
|
33 |
32 |
$1K |
| D2140 |
|
17 |
14 |
$765.30 |
| D0220 |
Intraoral - periapical first radiographic image |
43 |
37 |
$384.88 |
| D0601 |
|
13 |
13 |
$130.00 |
| D1999 |
|
31 |
31 |
$0.28 |