| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0210 |
Intraoral - complete series of radiographic images |
21,798 |
19,932 |
$1.17M |
| D1110 |
Prophylaxis - adult |
29,806 |
27,413 |
$918K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
35,233 |
32,286 |
$835K |
| D0120 |
Periodic oral evaluation - established patient |
34,093 |
31,990 |
$551K |
| D1354 |
|
13,479 |
1,647 |
$243K |
| D0140 |
Limited oral evaluation - problem focused |
7,669 |
7,081 |
$142K |
| D0230 |
Intraoral - periapical each additional radiographic image |
12,588 |
3,697 |
$62K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,603 |
3,025 |
$38K |
| D0220 |
Intraoral - periapical first radiographic image |
4,780 |
4,481 |
$24K |
| 92273 |
|
412 |
394 |
$20K |
| D5110 |
|
60 |
48 |
$15K |
| D5120 |
|
56 |
45 |
$13K |
| D0274 |
Bitewings - four radiographic images |
826 |
754 |
$13K |
| 92341 |
|
928 |
777 |
$9K |
| 65210 |
|
861 |
760 |
$9K |
| 11720 |
|
3,744 |
3,200 |
$9K |
| D7140 |
Extraction, erupted tooth or exposed root |
157 |
58 |
$7K |
| 92250 |
|
1,850 |
1,689 |
$6K |
| 11721 |
|
1,593 |
1,447 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
588 |
442 |
$5K |
| V2020 |
Frames, purchases |
695 |
535 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
446 |
413 |
$3K |
| 92557 |
|
384 |
368 |
$3K |
| D1206 |
Topical application of fluoride varnish |
139 |
114 |
$1K |
| 92015 |
Determination of refractive state |
260 |
224 |
$1K |
| G0127 |
Trimming of dystrophic nails, any number |
306 |
274 |
$854.63 |
| 99307 |
|
184 |
159 |
$469.50 |
| D1120 |
Prophylaxis - child |
17 |
17 |
$340.00 |
| 69210 |
|
171 |
137 |
$275.35 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
45 |
31 |
$0.00 |
| D1999 |
|
9,079 |
8,378 |
$0.00 |
| D9932 |
|
128 |
118 |
$0.00 |
| D9933 |
|
48 |
43 |
$0.00 |