| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| D8670 |
Periodic orthodontic treatment visit |
16,212 |
15,519 |
$1.55M |
| D8080 |
Comprehensive orthodontic treatment of the adolescent dentition |
1,176 |
1,145 |
$972K |
| D8680 |
|
665 |
619 |
$505K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
2,781 |
2,665 |
$122K |
| D0330 |
Panoramic radiographic image |
1,690 |
1,614 |
$99K |
| D0340 |
|
1,660 |
1,578 |
$85K |
| D0470 |
|
1,661 |
1,579 |
$70K |
| D0120 |
Periodic oral evaluation - established patient |
2,114 |
2,086 |
$51K |
| D2391 |
Resin-based composite - one surface, posterior, primary or permanent |
668 |
405 |
$50K |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
360 |
253 |
$36K |
| D1120 |
Prophylaxis - child |
1,247 |
1,233 |
$32K |
| D1110 |
Prophylaxis - adult |
745 |
736 |
$26K |
| D1206 |
Topical application of fluoride varnish |
1,271 |
1,257 |
$19K |
| D1351 |
Sealant - per tooth |
647 |
217 |
$17K |
| D0220 |
Intraoral - periapical first radiographic image |
1,096 |
1,078 |
$15K |
| D9110 |
|
309 |
299 |
$13K |
| D0230 |
Intraoral - periapical each additional radiographic image |
1,203 |
984 |
$13K |
| D0274 |
Bitewings - four radiographic images |
395 |
390 |
$12K |
| D0272 |
Bitewings - two radiographic images |
538 |
531 |
$9K |
| D1208 |
Topical application of fluoride, excluding varnish |
572 |
569 |
$9K |
| D9230 |
Inhalation of nitrous oxide / analgesia, anxiolysis |
209 |
191 |
$8K |
| D0240 |
|
250 |
136 |
$4K |
| D0140 |
Limited oral evaluation - problem focused |
94 |
94 |
$3K |
| D0145 |
Oral evaluation for a patient under three years of age |
64 |
52 |
$2K |
| D7140 |
Extraction, erupted tooth or exposed root |
20 |
12 |
$1K |