| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D7210 |
Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth |
4,505 |
2,217 |
$316K |
| D1110 |
Prophylaxis - adult |
3,261 |
3,036 |
$129K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
3,710 |
3,447 |
$88K |
| D2332 |
|
1,330 |
791 |
$78K |
| D0272 |
Bitewings - two radiographic images |
3,324 |
3,070 |
$45K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
993 |
749 |
$45K |
| D2160 |
|
577 |
450 |
$30K |
| D2335 |
|
448 |
273 |
$29K |
| D9110 |
|
1,022 |
949 |
$20K |
| D0220 |
Intraoral - periapical first radiographic image |
2,734 |
2,521 |
$20K |
| D1208 |
Topical application of fluoride, excluding varnish |
1,245 |
1,113 |
$17K |
| D2140 |
|
426 |
314 |
$16K |
| D7510 |
|
195 |
153 |
$8K |
| D1120 |
Prophylaxis - child |
174 |
150 |
$6K |
| D0230 |
Intraoral - periapical each additional radiographic image |
286 |
191 |
$2K |