| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D2930 |
Prefabricated stainless steel crown - primary tooth |
39,944 |
7,374 |
$4.72M |
| 00170 |
Anesthesia for intraoral procedures, including biopsy |
7,564 |
7,391 |
$2.04M |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14,671 |
4,291 |
$1.55M |
| 99201 |
|
14,376 |
4,435 |
$1.47M |
| D7140 |
Extraction, erupted tooth or exposed root |
20,353 |
5,725 |
$1.16M |
| D9420 |
|
12,524 |
8,717 |
$942K |
| D3220 |
Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction |
9,459 |
4,063 |
$936K |
| 41899 |
Unlisted procedure, dentoalveolar structures |
8,998 |
8,794 |
$927K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
9,288 |
8,725 |
$710K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
7,246 |
7,234 |
$458K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
6,636 |
2,417 |
$443K |
| D2330 |
|
4,303 |
1,774 |
$330K |
| D1120 |
Prophylaxis - child |
8,688 |
8,650 |
$302K |
| D0350 |
|
14,997 |
8,676 |
$280K |
| D0230 |
Intraoral - periapical each additional radiographic image |
18,172 |
8,657 |
$206K |
| D2932 |
|
1,786 |
600 |
$187K |
| D2929 |
|
1,663 |
592 |
$162K |
| D1208 |
Topical application of fluoride, excluding varnish |
8,622 |
8,602 |
$153K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
1,979 |
907 |
$106K |
| D0272 |
Bitewings - two radiographic images |
8,686 |
8,646 |
$102K |
| D2331 |
|
976 |
473 |
$77K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
520 |
247 |
$41K |
| D1351 |
Sealant - per tooth |
2,595 |
797 |
$37K |
| J7120 |
Ringers lactate infusion, up to 1000 cc |
2,591 |
2,590 |
$33K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
331 |
306 |
$17K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
93 |
88 |
$3K |
| D2332 |
|
24 |
13 |
$2K |
| D0145 |
Oral evaluation for a patient under three years of age |
50 |
50 |
$2K |
| D3120 |
|
4,454 |
1,164 |
$0.00 |