| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
5,693 |
4,464 |
$159K |
| D0120 |
Periodic oral evaluation - established patient |
6,776 |
5,306 |
$91K |
| D1999 |
|
5,360 |
4,282 |
$79K |
| D0272 |
Bitewings - two radiographic images |
2,480 |
1,892 |
$35K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
838 |
543 |
$34K |
| D0330 |
Panoramic radiographic image |
1,080 |
859 |
$33K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,006 |
524 |
$31K |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,543 |
1,699 |
$27K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,420 |
1,127 |
$20K |
| D2140 |
|
431 |
295 |
$12K |
| D1120 |
Prophylaxis - child |
490 |
387 |
$8K |
| D2160 |
|
126 |
81 |
$7K |
| D0140 |
Limited oral evaluation - problem focused |
131 |
112 |
$2K |
| D2330 |
|
73 |
37 |
$2K |
| D0220 |
Intraoral - periapical first radiographic image |
191 |
187 |
$2K |