| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D0140 |
Limited oral evaluation - problem focused |
3,489 |
3,219 |
$1.12M |
| D0150 |
Comprehensive oral evaluation - new or established patient |
1,843 |
1,747 |
$595K |
| D0120 |
Periodic oral evaluation - established patient |
801 |
762 |
$280K |
| D5899 |
|
750 |
561 |
$188K |
| D7140 |
Extraction, erupted tooth or exposed root |
1,333 |
859 |
$176K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
537 |
428 |
$107K |
| D2150 |
Silver amalgam - two surfaces, primary or permanent |
354 |
282 |
$83K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
284 |
213 |
$49K |
| D2140 |
|
171 |
136 |
$42K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
138 |
37 |
$23K |
| D2331 |
|
91 |
75 |
$16K |
| D2393 |
Resin-based composite - three surfaces, posterior, primary or permanent |
35 |
32 |
$8K |
| D2330 |
|
35 |
24 |
$6K |
| D2332 |
|
20 |
14 |
$1K |
| D1110 |
Prophylaxis - adult |
2,062 |
1,946 |
$83.02 |
| D0274 |
Bitewings - four radiographic images |
1,883 |
1,782 |
$32.29 |
| D0220 |
Intraoral - periapical first radiographic image |
3,493 |
3,274 |
$24.14 |
| D1206 |
Topical application of fluoride varnish |
752 |
704 |
$16.11 |
| D0230 |
Intraoral - periapical each additional radiographic image |
2,274 |
1,666 |
$8.03 |
| D0330 |
Panoramic radiographic image |
1,353 |
1,276 |
$0.00 |
| D1120 |
Prophylaxis - child |
58 |
58 |
$0.00 |
| D0210 |
Intraoral - complete series of radiographic images |
214 |
205 |
$0.00 |
| D0272 |
Bitewings - two radiographic images |
16 |
16 |
$0.00 |