| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0274 |
Bitewings - four radiographic images |
2,065 |
1,934 |
$61K |
| D0120 |
Periodic oral evaluation - established patient |
2,794 |
2,635 |
$59K |
| D1120 |
Prophylaxis - child |
1,920 |
1,809 |
$58K |
| D1208 |
Topical application of fluoride, excluding varnish |
3,086 |
2,907 |
$53K |
| D1110 |
Prophylaxis - adult |
924 |
871 |
$36K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
1,335 |
1,108 |
$34K |
| D2140 |
|
589 |
241 |
$20K |
| D0330 |
Panoramic radiographic image |
583 |
549 |
$19K |
| D0272 |
Bitewings - two radiographic images |
883 |
843 |
$17K |
| D0230 |
Intraoral - periapical each additional radiographic image |
548 |
496 |
$5K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
46 |
46 |
$1K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
17 |
12 |
$1K |
| D1999 |
|
42 |
30 |
$0.00 |