| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1120 |
Prophylaxis - child |
536 |
530 |
$17K |
| D0120 |
Periodic oral evaluation - established patient |
512 |
505 |
$13K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
229 |
227 |
$10K |
| D1110 |
Prophylaxis - adult |
196 |
193 |
$9K |
| D1208 |
Topical application of fluoride, excluding varnish |
432 |
426 |
$8K |
| D0272 |
Bitewings - two radiographic images |
272 |
272 |
$6K |
| D0330 |
Panoramic radiographic image |
186 |
181 |
$4K |
| D0210 |
Intraoral - complete series of radiographic images |
60 |
59 |
$3K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
87 |
83 |
$3K |
| D0140 |
Limited oral evaluation - problem focused |
217 |
204 |
$3K |
| D1206 |
Topical application of fluoride varnish |
61 |
61 |
$1K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
16 |
12 |
$1K |
| D0220 |
Intraoral - periapical first radiographic image |
90 |
90 |
$1K |
| D7140 |
Extraction, erupted tooth or exposed root |
17 |
15 |
$1K |
| D1999 |
|
13 |
13 |
$0.00 |