| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D1110 |
Prophylaxis - adult |
1,020 |
994 |
$43K |
| D0120 |
Periodic oral evaluation - established patient |
1,594 |
1,556 |
$39K |
| D1206 |
Topical application of fluoride varnish |
918 |
884 |
$15K |
| D0272 |
Bitewings - two radiographic images |
551 |
535 |
$12K |
| D0210 |
Intraoral - complete series of radiographic images |
136 |
132 |
$11K |
| D0140 |
Limited oral evaluation - problem focused |
325 |
320 |
$10K |
| D1120 |
Prophylaxis - child |
171 |
171 |
$6K |
| D0220 |
Intraoral - periapical first radiographic image |
314 |
308 |
$5K |
| D1208 |
Topical application of fluoride, excluding varnish |
119 |
118 |
$2K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
47 |
37 |
$1K |
| D2140 |
|
16 |
12 |
$1K |
| D1999 |
|
22 |
22 |
$0.00 |